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NPI Code Detail

MEDICARE: AUDREY MOTTA-WURST M.S.

MEDICARE:   AUDREY  MOTTA-WURST  M.S.
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1245712991
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY MOTTA-WURST M.S.
Provider Business Mailing Address
First Line : 714 MAIN ST UNIT C
Second Line :
City : YARMOUTH PORT
State : MA
Zip : 02675-2000
Country : US
Telephone Number : 508-313-9374
Fax Number : 833-563-2673
Provider Business Practice Location Address
First Line : 714 MAIN ST UNIT C
Second Line :
City : YARMOUTH PORT
State : MA
Zip : 02675-2000
Country : US
Telephone Number : 508-313-9374
Fax Number : 833-563-2673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2018
Last Update Date : 03/26/2024

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Directions to “ AUDREY MOTTA-WURST M.S.” Practice Location

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