MEDICARE: WENDY GUETLER M.S. 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

General Provider Information

NPI Number	:	1962065698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY GUETLER M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1312 BROADWAY RD
Second Line	:
City	:	LUTHERVILLE
State	:	MD
Zip	:	21093-1605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12250 ROUNDWOOD RD
Second Line	:
City	:	TIMONIUM
State	:	MD
Zip	:	21093-3233
Country	:	US
Telephone Number	:	443-809-4134
Fax Number	:

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

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	04/18/2019

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