Doctor Name: | STEPHEN WILLIAM SKUNDRICH |
NPI Number: | 1811258395 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS CCC-SLP |
License Number: | 146.005630 |
Business Practice Address: | 6837 Hampshire Ct Maryville, IL - 620628544 |
Business Phone Number: | 6185708192 |
Business Fax Number: | |
Mailing Address: | 6837 Hampshire Ct, MARYVILLE |
State: | IL |
Postal Code: | 620628544 |
Phone Number: | 6185708192 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2012 |
NPI Last Update Date: | 05/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.005630 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |