1831210764 NPI number — BECKY L FRANZ M.S. CCC-A

Table of content: BECKY L FRANZ M.S. CCC-A (NPI 1831210764)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831210764 NPI number — BECKY L FRANZ M.S. CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANZ
Provider First Name:
BECKY
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S. CCC-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831210764
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N3063 CTY HWY QQ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAUPACA
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54981-8105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-602-4046
Provider Business Mailing Address Fax Number:
715-258-0587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
N3063 CTY HWY QQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUPACA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54981-8105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-602-4046
Provider Business Practice Location Address Fax Number:
715-258-0587
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  267-156 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 267-156 . This is a "AUDIOLOGY LICENSE NUMBER" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 39-2036613 . This is a "FEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12004138 . This is a "ASHA CERTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41134300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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