Provider Demographics
NPI:1083053870
Name:EHRSTEIN, JOAN L (MA, CCC-SLP, IPLA)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:L
Last Name:EHRSTEIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP, IPLA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SOUTH STATE ROAD 49
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383
Mailing Address - Country:US
Mailing Address - Phone:219-465-1934
Mailing Address - Fax:
Practice Address - Street 1:275 S STATE ROAD 49
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-7976
Practice Address - Country:US
Practice Address - Phone:219-465-1934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22001805A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist