Patricia A Bohmer, MS-CCC
Individual provider Active NPI Speech-Language Pathologist · Cody, WY
NPI 1861702771 · NPPES record last updated Oct 13, 2010
Key facts
- NPI
- 1861702771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP-334 (WY)
- Practice address
- 54 Sage Dr
Cody, WY 82414-8228 - Phone
- (307) 899-2244
- NPI assigned
- Oct 13, 2010
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| SP-334 | WY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP-334 | WY | Yes |
Addresses
Primary practice location
54 Sage Dr
Cody, WY 82414-8228
Mailing address
54 Sage Dr
Cody, WY 82414-8228
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123133200 | Medicaid | WY |
Other providers in Cody, WY
- Sean Robert Binkley
- Steven A. Bischoff
- Kori Kae Black
- Krista Lee Blough
- Bodyworks Prosthetics and Orthotics LLC
- Kirk A Bollinger
- Karen S Bond
- Dwayne Steven Borgstrand
- Katie Bost
- Ryan Thomas Bower
All providers in Cody, WY · Speech-Language Pathologist in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.