Provider Demographics
NPI:1093824260
Name:DILLON, WENDY DYAN (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:DYAN
Last Name:DILLON
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:DYAN
Other - Last Name:NOLLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SPEECH LANGUAGE PATH
Mailing Address - Street 1:1134 EAST FINCASTLE TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:NORTH TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24630
Mailing Address - Country:US
Mailing Address - Phone:540-988-8765
Mailing Address - Fax:540-988-8764
Practice Address - Street 1:1134 EAST FINCASTLE TURNPIKE
Practice Address - Street 2:HEARTLAND REHABILITATION SERVICES
Practice Address - City:NORTH TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24630
Practice Address - Country:US
Practice Address - Phone:540-988-8765
Practice Address - Fax:540-988-8764
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist