Provider Demographics
NPI:1740445709
Name:WEXCOM INC DBA SHARON B WEXLER
Entity type:Organization
Organization Name:WEXCOM INC DBA SHARON B WEXLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEXLER
Authorized Official - Suffix:
Authorized Official - Credentials:SPEECH THERAPIST
Authorized Official - Phone:770-817-8002
Mailing Address - Street 1:11940 ALPHARETTA HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2003
Mailing Address - Country:US
Mailing Address - Phone:770-817-8002
Mailing Address - Fax:770-754-9609
Practice Address - Street 1:11940 ALPHARETTA HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2003
Practice Address - Country:US
Practice Address - Phone:770-817-8002
Practice Address - Fax:770-754-9609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP00249235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty