Provider Demographics
NPI:1023323375
Name:STENSVEN, MEREDITH LYN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LYN
Last Name:STENSVEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 OLLIE ST
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-9622
Mailing Address - Country:US
Mailing Address - Phone:608-219-1925
Mailing Address - Fax:
Practice Address - Street 1:455 OLLIE ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:WI
Practice Address - Zip Code:53527-9622
Practice Address - Country:US
Practice Address - Phone:608-219-1925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2778154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist