Provider Demographics
NPI:1689988404
Name:FIGUEROA, WANDA (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:
Last Name:FIGUEROA
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 1:3255 COUNTRYSIDE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7052
Mailing Address - Country:US
Mailing Address - Phone:407-892-4918
Mailing Address - Fax:
Practice Address - Street 1:3255 COUNTRYSIDE VIEW DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-7056
Practice Address - Country:US
Practice Address - Phone:407-892-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist