Mary Lynn Wietzke, CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01073833

Practice address

5500 Armstrong Road-114 PR
VA Medical Center
Battle Creek, MI 49015-1099

Phone

(269) 966-5600

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275547903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG ROAD-114 PR",
            "address_2": "VA MEDICAL CENTER",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151099",
            "telephone_number": "269-966-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ARMSTRONG ROAD-114 PR",
            "address_2": "VA MEDICAL CENTER",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151099",
            "telephone_number": "269-966-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETZKE",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "01073833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda White
• Florine Whitley, LMSW
• Ashley Whitt
• Marianne Wieland, LPN
• Clayton A. Wiersma, LMSW
• Catherine Grace Wilcox, DDS
• Jennifer Rocco Wilder, FNP-C
• Christopher Wilhelmson, M.D.
• Elizabeth Wilhelmson
• Janelle Kaprice Logan Wilkey, MSN, PMHNP-BC

• Speech-Language Pathologist in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.