Provider Demographics
NPI:1669743480
Name:STEFANIE J. PECK, M.A. CCC-SLP
Entity type:Organization
Organization Name:STEFANIE J. PECK, M.A. CCC-SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:440-498-1100
Mailing Address - Street 1:6325 COCHRAN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-3930
Mailing Address - Country:US
Mailing Address - Phone:440-498-1100
Mailing Address - Fax:440-498-1149
Practice Address - Street 1:6325 COCHRAN RD STE 2
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3930
Practice Address - Country:US
Practice Address - Phone:440-498-1100
Practice Address - Fax:440-498-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0700X
OHSP6712261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech