Individual
MRS. WENDY NICOLE PETRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
13335 BROADWAY ST, FOLSOM, LA 70437-6171
(985) 502-1319
Mailing address
13335 BROADWAY ST, FOLSOM, LA 70437-6171
(985) 502-1319
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5768
LA
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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