Doctor Name: | WENDI WYLIE |
NPI Number: | 1619370335 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SLP00333 |
Business Practice Address: | 1091 Park Dr Suite B Watkinsville, GA - 306772014 |
Business Phone Number: | 7702076390 |
Business Fax Number: | 6783744855 |
Mailing Address: | 1091 Park Dr, Suite B WATKINSVILLE |
State: | GA |
Postal Code: | 306772014 |
Phone Number: | 7702076390 |
Fax Number: | 6783744855 |
NPI Enumeration Date: | 10/08/2014 |
NPI Last Update Date: | 10/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP00333 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |