Provider Demographics
NPI:1285764688
Name:SHEVOCK, WENDY MARIE (MSCCC-SLP)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:MARIE
Last Name:SHEVOCK
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 HOWARD ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-2362
Mailing Address - Country:US
Mailing Address - Phone:814-437-3071
Mailing Address - Fax:
Practice Address - Street 1:191 HOWARD ST
Practice Address - Street 2:SUITE 105
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-2362
Practice Address - Country:US
Practice Address - Phone:814-437-3071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist