Provider Demographics
NPI:1073373908
Name:WIENCEK, ZOE LUCREZIA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:LUCREZIA
Last Name:WIENCEK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MILBURN LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5995
Mailing Address - Country:US
Mailing Address - Phone:716-720-6018
Mailing Address - Fax:
Practice Address - Street 1:1014 ADAMS POINT DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6575
Practice Address - Country:US
Practice Address - Phone:919-359-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NC30002670235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist