Wyanetha Renner, Ma,ccc/slp, Pa

NPI 1598025769 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1598025769
Enumeration Date 05/22/2012
Last Updated 05/22/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name WYANETHA WYANETHA
Position PRESIDENT
Phone (321) 303-4320
Fax
Practice Location
22 LAKE BEAUTY DR
STE 304
ORLANDO FL, 32806-2037, US
Phone (321) 303-4320
Fax
Business Location
2182 CRANDON AVE
WINTER PARK FL, 32789-3382, US
Phone (321) 303-4320
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Florida
License Number SA6648
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According to our database, Wyanetha Renner, Ma,ccc/slp, Pa NPI is 1598025769, taxonomy code is 235Z00000X and license number is SA6648, license state is located at Florida. Wyanetha Renner, Ma,ccc/slp, Pa physically located at 22 Lake Beauty Dr, Orlando FL, 32806-2037. NPI Number 1033115704 has the healthcare provider type.

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1598025769 NPI number is provided on an as is basis without warranty of any kind. 1598025769 is maintained by the National Plan & Provider Enumeration System. The contents of Wyanetha Renner, Ma,ccc/slp, Pa are for informational purposes only.