Wendi M Jorgensen, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Matamoras, OH

NPI 1376042390 · NPPES record last updated Apr 24, 2020

Key facts

NPI
1376042390
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP11829 (OH)
Practice address
44870 Oh-7
Matamoras, OH 45767
Phone
(740) 865-3473
NPI assigned
Feb 5, 2018
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
SP11829OHMDSpeech-Language Pathologist
LL60793488WAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP11829 OH Yes
Speech-Language Pathologist 235Z00000X LL60793488 WA

Addresses

Primary practice location

44870 Oh-7
Matamoras, OH 45767

Mailing address

44870 Oh-7
Matamoras, OH 45767
Phone (703) 627-1737

Other providers in Matamoras, OH

All providers in Matamoras, OH · Speech-Language Pathologist in Ohio

Sources for this page

Verify at the official NPI Registry.