Provider Demographics
NPI:1942641436
Name:GORYCA-ROONEY, WENDY TERESE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:TERESE
Last Name:GORYCA-ROONEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1608
Mailing Address - Country:US
Mailing Address - Phone:248-561-3222
Mailing Address - Fax:
Practice Address - Street 1:500 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-7206
Practice Address - Country:US
Practice Address - Phone:248-608-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist