MEDICARE: MS. KATHRYN J WILHELM M.S., 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	109084	TX

General Provider Information

NPI Number	:	1134635915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHRYN J WILHELM M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	1518 WASHINGTON AVE APT G
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-7755
Country	:	US
Telephone Number	:	806-690-3613
Fax Number	:

Provider Business Practice Location Address
First Line	:	1518 WASHINGTON AVE APT G
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-7755
Country	:	US
Telephone Number	:	180-669-0361
Fax Number	:	806-690-3613

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

Provider Enumeration Date	:	12/15/2017
Last Update Date	:	12/15/2017

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