Provider Demographics
NPI:1407048176
Name:SCHECKEL, DENNETTE L (MHS, CCC/SLP/L)
Entity Type:Individual
Prefix:
First Name:DENNETTE
Middle Name:L
Last Name:SCHECKEL
Suffix:
Gender:F
Credentials:MHS, CCC/SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11825 213TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:WI
Mailing Address - Zip Code:53104-9682
Mailing Address - Country:US
Mailing Address - Phone:262-690-1507
Mailing Address - Fax:
Practice Address - Street 1:11825 213TH AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:WI
Practice Address - Zip Code:53104-9682
Practice Address - Country:US
Practice Address - Phone:262-690-1507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146005608235Z00000X
WI2737154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist