Provider Demographics
NPI:1841448164
Name:CATES, WENDY B (AUD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:B
Last Name:CATES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:BETH
Other - Last Name:CATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:80 LACY ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1107
Mailing Address - Country:US
Mailing Address - Phone:770-427-0368
Mailing Address - Fax:770-427-0368
Practice Address - Street 1:80 LACY ST NW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1107
Practice Address - Country:US
Practice Address - Phone:770-427-0368
Practice Address - Fax:770-427-0368
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0491231H00000X
NC9874231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC02-0639126OtherEMPLOYER ID
KY611328413OtherEMPLOYER ID 61-1328413
KY7100136540Medicaid
KY058915Medicare PIN
NCQ39279AMedicare PIN