Wendy Colleen Phou | Jacksonville Beach, FL • PECOS Search

Wendy Colleen Phou

Speech-Language Pathologist

Speech, Language and Hearing Service Providers

2730 Isabella Blvd, Jacksonville Beach, FL 32250-8001

(904) 372-4070 (904) 910-3858

PECOS Enrollment

Based on the most recent information from CMS, provider Wendy Colleen Phou does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1184293938
Provider Type
Individual
Full Name
Phou, Wendy Colleen
Title
Ms.
Credential
M.S., CF-SLP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/24/2021
Last Updated
6/24/2021

Contact Information

Practice Location

2730 Isabella Blvd, Jacksonville Beach, FL 32250-8001

Unlisted Fax

Mailing Location

12323 Amanda Cove Trl, Jacksonville, FL 32225-5156

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 235Z00000X Primary	Description Speech-Language Pathologist Speech, Language and Hearing Service Providers	License SZ10126 Florida