MEDICARE: DR. SHERI TRACY STRONACH PHD CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2782-154	WI
2	235Z00000X	Speech-Language Pathologist	488158	MN

General Provider Information

NPI Number	:	1871600296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERI TRACY STRONACH PHD CCC-SLP

Provider Business Mailing Address
First Line	:	268 WILDWOOD AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55110-1623
Country	:	US
Telephone Number	:	608-334-1597
Fax Number	:

Provider Business Practice Location Address
First Line	:	268 WILDWOOD AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55110-1623
Country	:	US
Telephone Number	:	608-334-1597
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	04/12/2019

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Directions to “ DR. SHERI TRACY STRONACH PHD CCC-SLP” Practice Location

Language	Start Address	Practice Location

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