MEDICARE: DR. MARGARET VENTO-WILSON PHD, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	21747	CA

General Provider Information

NPI Number	:	1043947252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET VENTO-WILSON PHD, CCC-SLP

Provider Business Mailing Address
First Line	:	3809 PINE AVENUE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807
Country	:	US
Telephone Number	:	562-243-2334
Fax Number	:

Provider Business Practice Location Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	SUITE 5046
City	:	LONG BEACH
State	:	CA
Zip	:	90807-9080
Country	:	US
Telephone Number	:	562-243-2334
Fax Number	:	562-988-0888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2022
Last Update Date	:	08/07/2022

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Directions to “ DR. MARGARET VENTO-WILSON PHD, CCC-SLP” Practice Location

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