Provider Demographics
NPI:1447330337
Name:WAINWRIGHT, DOLORES (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:
Last Name:WAINWRIGHT
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 1:11309 LITTLE BEAR DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2609
Mailing Address - Country:US
Mailing Address - Phone:561-482-4272
Mailing Address - Fax:561-482-4272
Practice Address - Street 1:11309 LITTLE BEAR DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2609
Practice Address - Country:US
Practice Address - Phone:561-482-4272
Practice Address - Fax:561-482-4272
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5790235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist