Sue Anne Wakeland, MED CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5319199-4102 Issued in UT

Practice address

25 Alpine Ave
Pleasant Grove, UT 84062-3511

Phone

(801) 785-3568

NPI assigned

Jun 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386841997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 E 800 N",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621957",
            "telephone_number": "801-796-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ALPINE AVE",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623511",
            "telephone_number": "801-785-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKELAND",
        "first_name": "SUE",
        "middle_name": "ANNE",
        "credential": "MED CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "5319199-4102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870574059031",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larell C. Van Dyke, D.D.S.
• Pamela Wilson Vandenaker, M.S.
• Jennie Vandyke
• Julie Ann Vanwagoner, ACMHC
• Beverly L Vargo, M.D.
• Walgreen Co
• Abigail Wallace
• Walmart Inc.
• Suzanne Walsh
• Jess Walters, MMP, LMT

• Speech-Language Pathologist in Pleasant Grove, UT
• Providers in Pleasant Grove, UT by specialty
• Speech-Language Pathologist in Utah

• 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.