Provider Demographics
NPI:1538761218
Name:PEITZER, WENDY SARNER (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:SARNER
Last Name:PEITZER
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 1:10 BERRY LN
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-3425
Mailing Address - Country:US
Mailing Address - Phone:201-826-6937
Mailing Address - Fax:
Practice Address - Street 1:10 BERRY LN
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-3425
Practice Address - Country:US
Practice Address - Phone:201-826-6937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist