Provider Demographics
NPI:1073733309
Name:ALDINGER, WANDA (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:
Last Name:ALDINGER
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 PEACHTREE STREET EAST
Mailing Address - Street 2:SUITE 149
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:678-481-6444
Mailing Address - Fax:678-817-7652
Practice Address - Street 1:156 PEACHTREE STREET EAST
Practice Address - Street 2:SUITE 149
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:678-481-6444
Practice Address - Fax:678-817-7652
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA86126910AMedicaid