Provider Demographics
NPI:1871127167
Name:GUGGISBERG, WENDY ELLEN
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ELLEN
Last Name:GUGGISBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 BOETTGER RD
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-2011
Mailing Address - Country:US
Mailing Address - Phone:507-276-1822
Mailing Address - Fax:
Practice Address - Street 1:NEW ULM MEDICAL CENTER
Practice Address - Street 2:1324 5TH NORTH ST
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073
Practice Address - Country:US
Practice Address - Phone:507-217-5685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN201030224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant