Provider Demographics
NPI:1104442045
Name:BEKHOR, WENDY MICHELLE
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MICHELLE
Last Name:BEKHOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14141 CITRUS CREST CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3110
Mailing Address - Country:US
Mailing Address - Phone:813-943-1203
Mailing Address - Fax:
Practice Address - Street 1:14141 CITRUS CREST CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3110
Practice Address - Country:US
Practice Address - Phone:813-943-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW146361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical