Provider Demographics
NPI:1831930569
Name:WNC SPEECH PATHOLOGY, PLLC
Entity type:Organization
Organization Name:WNC SPEECH PATHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:VANDERWIELE
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:828-482-4125
Mailing Address - Street 1:PO BOX 1462
Mailing Address - Street 2:
Mailing Address - City:CASHIERS
Mailing Address - State:NC
Mailing Address - Zip Code:28717-1462
Mailing Address - Country:US
Mailing Address - Phone:828-482-4125
Mailing Address - Fax:828-285-1236
Practice Address - Street 1:894 HIGHWAY 107 SOUTH
Practice Address - Street 2:
Practice Address - City:CASHIERS
Practice Address - State:NC
Practice Address - Zip Code:28717
Practice Address - Country:US
Practice Address - Phone:828-482-4125
Practice Address - Fax:828-285-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty