Provider Demographics
NPI:1073821534
Name:ATKINS, WENDY (CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 BEDFORD AVE
Mailing Address - Street 2:1K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2651
Mailing Address - Country:US
Mailing Address - Phone:718-891-1107
Mailing Address - Fax:718-769-0020
Practice Address - Street 1:4750 BEDFORD AVE
Practice Address - Street 2:1K
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2651
Practice Address - Country:US
Practice Address - Phone:718-891-1107
Practice Address - Fax:718-769-0020
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000404-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist