MEDICARE: MRS. KRISTIN WURIE M.A., 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	07165	MD

General Provider Information

NPI Number	:	1447522412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN WURIE M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	9440 PENNSYLVANIA AVE
Second Line	:	SUITE 210
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3659
Country	:	US
Telephone Number	:	301-297-4022
Fax Number	:	301-297-4050

Provider Business Practice Location Address
First Line	:	9440 PENNSYLVANIA AVE
Second Line	:	SUITE 210
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3659
Country	:	US
Telephone Number	:	301-297-4022
Fax Number	:	301-297-4050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2012
Last Update Date	:	08/16/2013

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Directions to “ MRS. KRISTIN WURIE M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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