Provider Demographics
NPI:1124886130
Name:ALVARENGA-AGUIRRE, WENDY LETICIA
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LETICIA
Last Name:ALVARENGA-AGUIRRE
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 1:901 N WINSTEAD AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-8757
Mailing Address - Country:US
Mailing Address - Phone:252-210-6530
Mailing Address - Fax:
Practice Address - Street 1:901 N WINSTEAD AVE STE 260
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8757
Practice Address - Country:US
Practice Address - Phone:252-210-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0193161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical