Provider Demographics
NPI:1104173830
Name:HILL, WENDY ELLEN (MS,ED)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ELLEN
Last Name:HILL
Suffix:
Gender:F
Credentials:MS,ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5K SANDY POINTE DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-4649
Mailing Address - Country:US
Mailing Address - Phone:518-248-8587
Mailing Address - Fax:
Practice Address - Street 1:5K SANDY POINTE DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-4649
Practice Address - Country:US
Practice Address - Phone:518-248-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY842022174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist