Provider Demographics
NPI:1336318732
Name:DWIGANS, WENDY K F (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:K F
Last Name:DWIGANS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:FT EISENHOWER
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:706-787-7300
Mailing Address - Fax:
Practice Address - Street 1:428 22ND ST BLDG 21712
Practice Address - Street 2:
Practice Address - City:FT EISENHOWER
Practice Address - State:GA
Practice Address - Zip Code:30905-5303
Practice Address - Country:US
Practice Address - Phone:706-787-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002377A231H00000X
WI357-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist