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General NPI Number Information
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NPI Number | 1003012865
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Entity Type | Individual
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Provider Name | WENDY ANN LUCIER MS-CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2200 IRONWOOD PL
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2610
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Country | US
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Telephone | 208-667-8276
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 385
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City | CAREYWOOD
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State | ID
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Zip | 83809-0385
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Country | US
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Telephone | 208-683-2509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP1126
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License Number State | ID
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