Provider Demographics
NPI:1336324631
Name:LAWHORN, WENDY MATHERNE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MATHERNE
Last Name:LAWHORN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 SUGER PLUM ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-4482
Mailing Address - Country:US
Mailing Address - Phone:850-890-2389
Mailing Address - Fax:
Practice Address - Street 1:440 SUGAR PLUM ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-4482
Practice Address - Country:US
Practice Address - Phone:850-890-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist