Provider Demographics
NPI:1932383155
Name:MARTIN, WENDY (BA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 EAST 7TH ST.
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4606
Mailing Address - Country:US
Mailing Address - Phone:559-488-7538
Mailing Address - Fax:559-441-1590
Practice Address - Street 1:410 EAST 7TH ST.
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4606
Practice Address - Country:US
Practice Address - Phone:559-488-7538
Practice Address - Fax:559-441-1590
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)