Carol K Lanza, MS-CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · Luck, WI
NPI 1023313426 · NPPES record last updated Jan 14, 2011
Key facts
- NPI
- 1023313426
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 395154 (WI)
- Practice address
- 210 E Park Ave
Luck, WI 54853-9066 - Phone
- (715) 472-3114
- NPI assigned
- Jan 14, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 395154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 395154 | WI | Yes |
Addresses
Primary practice location
210 E Park Ave
Luck, WI 54853-9066
Mailing address
6492 Burnikel Rd
Siren, WI 54872-9118
Phone (715) 349-5279
Other providers in Luck, WI
- Christiane Herman
- Jaimee Holdt
- Richard Alfred Huset
- Mandy R Jeske
- Amelia Pearl King
- Luck Dental Clinic, Inc.
- Luck Pharmacy Inc
- Amy Magnuson
- Erin E McCreary
- Meaningful Connections Therapy
All providers in Luck, WI · Speech-Language Pathologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.