Individual
LAURA WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. , CCC-SLP
Contact information
Practice address
204 SUMMERSET DR, PAPILLION, NE 68133-2821
(402) 415-3749
Mailing address
204 SUMMERSET DR, PAPILLION, NE 68133-2821
(402) 415-3749
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12110460
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011004867
NDE STAFF 2011004867
NE
Enumeration date
11/03/2015
Last updated
09/10/2023
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