Provider Demographics
NPI:1417200650
Name:MUELLER, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:MUELLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HIGH BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8451
Mailing Address - Country:US
Mailing Address - Phone:854-888-0153
Mailing Address - Fax:854-999-4229
Practice Address - Street 1:105 HIGH BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8451
Practice Address - Country:US
Practice Address - Phone:854-888-0153
Practice Address - Fax:854-999-4229
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist