Provider Demographics
NPI:1689992802
Name:ALONSO, WENDY GRASHOFF (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:GRASHOFF
Last Name:ALONSO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:ANN
Other - Last Name:GRASHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:102 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1746
Mailing Address - Country:US
Mailing Address - Phone:985-768-8660
Mailing Address - Fax:
Practice Address - Street 1:102 STRATFORD DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1746
Practice Address - Country:US
Practice Address - Phone:985-768-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist