Organization
PARIT MORTEM SPEECH AND LANGUAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JOSEPHINE WIENCKEN (PROVIDER)
(901) 834-1394
Entity
Organization
Contact information
Practice address
3566 FOXFIELD TRL, BARTLETT, TN 38135-3004
(901) 834-1394
Mailing address
3566 FOXFIELD TRL, BARTLETT, TN 38135-3004
(901) 834-1394
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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