Provider Demographics
NPI:1902353352
Name:WENDEL, LAURA MARIE (MS, CGC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:WENDEL
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MARIE
Other - Last Name:HAUGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:8365 TILIA LN
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-8231
Mailing Address - Country:US
Mailing Address - Phone:320-221-3537
Mailing Address - Fax:
Practice Address - Street 1:3931 LOUISIANA AVE S STE E111
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-5000
Practice Address - Country:US
Practice Address - Phone:952-993-7489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS