Doctor Name: | JOANNA LYNN WYCKOFF |
NPI Number: | 1578949814 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 5015 E 29th St N Door T Wichita, KS - 672202110 |
Business Phone Number: | 3169783289 |
Business Fax Number: | 3169787264 |
Mailing Address: | 1845 Fairmount St, Campus Box 99 WICHITA |
State: | KS |
Postal Code: | 672600099 |
Phone Number: | 3169783289 |
Fax Number: | 3169787264 |
NPI Enumeration Date: | 08/10/2015 |
NPI Last Update Date: | 08/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |