Provider Demographics
NPI:1427262872
Name:SMITH-SCHULTZ, ERIN L (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:SMITH-SCHULTZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:L
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2150 EASTRIDGE CTR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-3403
Mailing Address - Country:US
Mailing Address - Phone:715-895-8000
Mailing Address - Fax:833-252-6410
Practice Address - Street 1:2150 EASTRIDGE CTR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3403
Practice Address - Country:US
Practice Address - Phone:715-895-8000
Practice Address - Fax:833-252-6410
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2270154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42797900Medicaid
ND1477800Medicaid