MEDICARE: WENDY FERRARA, MA, 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	5557	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	018AH	OTHER	NC	BLUE CROSS BLUE SHIELD OF NC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730372202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WENDY FERRARA, MA, CCC-SLP

Provider Business Mailing Address
First Line	:	2010 CEDAR GROVE DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-9372
Country	:	US
Telephone Number	:	919-523-2154
Fax Number	:	919-361-9188

Provider Business Practice Location Address
First Line	:	2010 CEDAR GROVE DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-9372
Country	:	US
Telephone Number	:	919-523-2154
Fax Number	:	919-361-9188

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	MRS. WENDY FERRARA
Credential	:	M.A., CCC-SLP
Telephone Number	:	919-523-2154

Provider Enumeration Date	:	08/19/2007
Last Update Date	:	06/20/2008

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