Provider Demographics
NPI:1992923098
Name:CRANDALL-COHEN, WENDY MARIE (MA, MFT)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MARIE
Last Name:CRANDALL-COHEN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 MORRO DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-5520
Mailing Address - Country:US
Mailing Address - Phone:818-716-6728
Mailing Address - Fax:
Practice Address - Street 1:2504 W MANCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-2520
Practice Address - Country:US
Practice Address - Phone:323-751-3805
Practice Address - Fax:323-750-5885
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41754106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist