| Tara Wittrock, CCC/SLP | |
|
4791 County Road 10 Ste 102, Moose Lake, MN 55767-9221 | |
| (218) 485-2020 | |
| (218) 485-2044 |
| Full Name | Tara Wittrock |
|---|---|
| Gender | Female |
| Speciality | Qualified Speech Language Pathologist |
| Experience | 12 Years |
| Location | 4791 County Road 10 Ste 102, Moose Lake, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871906891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 9592 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Therapy Partners Inc | 4486552593 | 122 |
| Provider Name | Therapy Partners Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1407809494 PECOS PAC ID: 4486552593 Enrollment ID: O20031229000333 |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Wittrock, CCC/SLP 1939 Minnehaha Ave W Ste 300, Saint Paul, MN 55104-1033 Ph: (651) 748-4338 | Tara Wittrock, CCC/SLP 4791 County Road 10 Ste 102, Moose Lake, MN 55767-9221 Ph: (218) 485-2020 |
Rebecca Lou Lief-kuster, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4761 Coffee Lake Rd, Moose Lake, MN 55767 Phone: 218-341-0212 | |
Keri A Halverson, CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4572 County Road 61, Moose Lake, MN 55767 Phone: 218-485-4481 | |
Elizabeth Luoma, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4570 County Road 61, Moose Lake, MN 55767 Phone: 218-485-2020 |