Provider Demographics
NPI:1952629099
Name:KORN, WENDI (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:WENDI
Middle Name:
Last Name:KORN
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 1:102 S HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3731
Mailing Address - Country:US
Mailing Address - Phone:410-809-6052
Mailing Address - Fax:
Practice Address - Street 1:2100 CONOWINGO RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-1843
Practice Address - Country:US
Practice Address - Phone:410-638-4170
Practice Address - Fax:410-809-6179
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009684235Z00000X
MD07238235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist