Provider Demographics
NPI:1932488780
Name:KUEGELER WOLTERS, ELIZABETH ANN (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:KUEGELER WOLTERS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:KUEGELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ELIZABETH KUEGELER
Mailing Address - Street 1:ADELGUNDENSTRASSE 31
Mailing Address - Street 2:
Mailing Address - City:NUREMBERG
Mailing Address - State:BAVARIA
Mailing Address - Zip Code:90419
Mailing Address - Country:DE
Mailing Address - Phone:911-322-6352
Mailing Address - Fax:911-322-6358
Practice Address - Street 1:ADELGUNDENSTRASSE 31
Practice Address - Street 2:
Practice Address - City:NUREMBERG
Practice Address - State:BAVARIA
Practice Address - Zip Code:90419
Practice Address - Country:DE
Practice Address - Phone:911-322-6352
Practice Address - Fax:911-322-6358
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist