Individual provider · Type 1 NPI
Mary Carol Wietzke, SLPA
Speech-Language Assistant · Whiteriver, AZ
NPI number
1760388920
Active
Practice location
4325 Fort Apache Rd., Building 3
Whiteriver, AZ 85941
Mailing address
PO Box 1157
Fort Apache, AZ 85926-1157
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Assistant Primary | 2355S0801X | SLPA17703 (AZ) |
Speech-Language Assistant: Definition to come...
Other speech-language assistant providers in Whiteriver
About NPI 1760388920
Mary Carol Wietzke, SLPA's National Provider Identifier is 1760388920, issued on Oct 15, 2026. The primary taxonomy on file is Speech-Language Assistant (2355S0801X), and the practice location is in Whiteriver, AZ. The record was last updated on Oct 15, 2026.