Provider Demographics
NPI:1083899801
Name:KLEIN, WENDY REBECCA (LMFT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:REBECCA
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:REBECCA
Other - Last Name:ROSENBLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:380 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3745
Mailing Address - Country:US
Mailing Address - Phone:978-266-1991
Mailing Address - Fax:
Practice Address - Street 1:380 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3745
Practice Address - Country:US
Practice Address - Phone:978-266-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001504A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist