Individual
MRS. COURTNEY A WENGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC - SLP
Contact information
Practice address
51 E MAIN ST, AVON, CT 06001-3821
(860) 404-2461
Mailing address
PO BOX 484, AVON, CT 06001-0484
(860) 677-4048
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004128
CT
Other
Enumeration date
01/14/2010
Last updated
05/29/2012
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