Provider Demographics
NPI:1487280830
Name:PRICE, WENDY LYNN
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:PRICE
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 1:221 SE 3RD AVE APT 8B
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4563
Mailing Address - Country:US
Mailing Address - Phone:727-420-1310
Mailing Address - Fax:
Practice Address - Street 1:221 SE 3RD AVE APT 8B
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-4563
Practice Address - Country:US
Practice Address - Phone:727-420-1310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health