Individual ProviderAmanda WygrysSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address4208 Retama Cir, Victoria, TX 77901-2765(361) 578-2257(613) 578-2257PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Wygrys does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1881324598Provider TypeIndividualFull NameWygrys, AmandaCredentialMS-SLP-CCCGenderFemaleSole ProprietorYesEnumeration Date6/15/2022Last Updated6/15/2022Contact InformationPractice LocationPractice Address4208 Retama Cir, Victoria, TX 77901-2765Phone(361) 578-2257Fax(361) 578-2260Mailing LocationMailing Address4208 Retama Cir, Victoria, TX 77901-2765Phone(613) 578-2257Fax(361) 578-2260Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense119734TexasProvider IdentifiersIDDescriptionIssuerID119734DescriptionOtherIssuerTEXAS LICENSETexas