Individual
DAWN WILDERMUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC/SLP
Contact information
Practice address
2574 COMMERCE PKWY, NORTH PORT, FL 34289-9334
(941) 485-0121
(941) 485-0591
Mailing address
1210 LEXINGTON DR., VENICE, FL 34292
(941) 468-6701
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA0000934
FL
Other
Enumeration date
10/02/2006
Last updated
12/26/2023
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