Provider Demographics
NPI:1699779926
Name:SCHUETT, WENDY KOENIG (AUD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:KOENIG
Last Name:SCHUETT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1186 GRAVES AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-5439
Mailing Address - Country:US
Mailing Address - Phone:970-586-5255
Mailing Address - Fax:970-577-7260
Practice Address - Street 1:1186 GRAVES AVE
Practice Address - Street 2:UNIT B
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-5439
Practice Address - Country:US
Practice Address - Phone:970-586-5255
Practice Address - Fax:970-577-7260
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO27231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00342665OtherRR MEDICARE
COCO662230OtherBC/BS
COS31330Medicare UPIN
COP00342665OtherRR MEDICARE