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General NPI Number Information
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NPI Number | 1831930569
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Entity Type | Organization
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Legal Business Name | WNC SPEECH PATHOLOGY, PLLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 894 HIGHWAY 107 SOUTH
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City | CASHIERS
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State | NC
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Zip | 28717
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Country | US
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Telephone | 828-482-4125
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Fax | 828-285-1236
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Provider Business Mailing Address
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Address Line | PO BOX 1462
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City | CASHIERS
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State | NC
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Zip | 28717-1462
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Country | US
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Telephone | 828-482-4125
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Fax | 828-285-1236
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LAURIE C VANDERWIELE
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Credential | MCD, CCC-SLP
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Telephone | 828-482-4125
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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 |
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License Number State |
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