Ann-Therese Nicole Wilder, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6182 Issued in MA

Practice address

111 Dodge St
Beverly, MA 01915-1827

Phone

(978) 921-1182

NPI assigned

Nov 17, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ann-Therese Nicole Mueller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Arc, Inc.

  • Early Intervention Provider Agency
  • Beverly, MA
  • NPI 1629356613
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1205138641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151827",
            "telephone_number": "978-921-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "ANN-THERESE",
        "middle_name": "NICOLE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN-THERESE",
            "last_name": "MUELLER",
            "middle_name": "NICOLE",
            "credential": "MS, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Whitney, DMD
• Debra Anne Whitten, CCC/SLP
• Mackenzie Whittet, COTA/L
• Wholeness Counseling, LLC
• Lena-Anne Wickham
• Kate Taylor Wilkins
• Christopher Robert Williams
• Gretchen Lea Williams, MA
• Linda G. Williams, CRNA
• Megan Williams

• Speech-Language Pathologist in Beverly, MA
• Providers in Beverly, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.