Individual
ANDREA WENZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1820 BOYD ST, CHILLICOTHE, MO 64601-1212
(660) 707-1106
Mailing address
1820 BOYD ST, CHILLICOTHE, MO 64601-1212
(660) 707-1106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004016687
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34637013
BLUE CROSS BLUE SHIELD
MO
Enumeration date
10/04/2006
Last updated
12/06/2007
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