Provider Demographics
NPI:1255304366
Name:SCHULTZ, ERICA (MS-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:MS-CCC/SLP
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:PAULSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2120 HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6142
Mailing Address - Country:US
Mailing Address - Phone:715-832-1681
Mailing Address - Fax:715-514-5210
Practice Address - Street 1:2120 HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6142
Practice Address - Country:US
Practice Address - Phone:715-832-1681
Practice Address - Fax:715-514-5210
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3658-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN656T8PAOtherMN BCBS NUMBER
1255304366OtherNPI
MNHP59052OtherMN HEALTHPARTNERS NUMBER
MN7514730OtherMN AETNA NUMBER