Provider Demographics
NPI:1053728303
Name:SCHWARTZ, KIRSTEN (MA/ CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MA/ CCC-SLP
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:
Other - Last Name:PFEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA/CF-SLP
Mailing Address - Street 1:2433 CHARLOTTE CT
Mailing Address - Street 2:APT 3
Mailing Address - City:ANTIGO
Mailing Address - State:WI
Mailing Address - Zip Code:54409-2951
Mailing Address - Country:US
Mailing Address - Phone:920-570-1551
Mailing Address - Fax:
Practice Address - Street 1:333 PINE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4102
Practice Address - Country:US
Practice Address - Phone:715-847-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3973-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist