Wendy Jones Pulliam, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Victoria, VA

NPI 1710102256 · NPPES record last updated Apr 3, 2013

Key facts

NPI
1710102256
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2202005151 (VA)
Practice address
2027 8TH St
Victoria, VA 23974-4506
Phone
(434) 395-2972
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202005151VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Longwood University Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202005151 VA Yes

Addresses

Primary practice location

2027 8TH St
Victoria, VA 23974-4506

Mailing address

2027 8TH St
PO Box 961
Victoria, VA 23974-4506

Other identifiers

IdentifierTypeStateIssuer
004979907MedicaidVA

Other providers in Victoria, VA

All providers in Victoria, VA · Speech-Language Pathologist in Virginia

Sources for this page

Verify at the official NPI Registry.