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NPI Code Detail

MEDICARE: BROOKLYN EILEEN WENDT M.A., CF-SLP

MEDICARE:   BROOKLYN EILEEN WENDT  M.A., CF-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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1275109472
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKLYN EILEEN WENDT M.A., CF-SLP
Provider Business Mailing Address
First Line : 508 MAIN ST
Second Line :
City : ANITA
State : IA
Zip : 50020-1033
Country : US
Telephone Number : 712-249-8218
Fax Number :
Provider Business Practice Location Address
First Line : 2401 E 8TH ST
Second Line :
City : DES MOINES
State : IA
Zip : 50316-1717
Country : US
Telephone Number : 828-297-6452
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2021
Last Update Date : 05/28/2021

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Directions to “ BROOKLYN EILEEN WENDT M.A., CF-SLP” Practice Location

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