Maureen Lucille Cellmer

Individual provider Active NPI Speech-Language Pathologist · Casper, WY

NPI 1295870251 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1295870251
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP-265 (WY)
Practice address
3570 Misty Mountain Rd
Casper, WY 82601-9764
Phone
(307) 267-5844
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SP-265WYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-265 WY Yes

Addresses

Primary practice location

3570 Misty Mountain Rd
Casper, WY 82601-9764

Mailing address

3570 Misty Mountain Rd
Casper, WY 82601-9764
Phone (307) 267-5844

Other identifiers

IdentifierTypeStateIssuer
113041200MedicaidWY

Other providers in Casper, WY

All providers in Casper, WY · Speech-Language Pathologist in Wyoming

Sources for this page

Verify at the official NPI Registry.