Individual
MS. ELAINE MARIA STEVICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., C.C.C.-SLP
Contact information
Practice address
1301 REDWOOD WAY, SUITE 165, PETALUMA, CA 94954-1107
(707) 763-6419
(707) 763-2537
Mailing address
1301 REDWOOD WAY, SUITE 165, PETALUMA, CA 94954-1107
(707) 763-6419
(707) 763-2537
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP2710
SPEECH PATH LICENSE
CA
Enumeration date
01/25/2007
Last updated
07/08/2007
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