Provider Demographics
NPI:1144231804
Name:UPADHYAY, WENDY S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:S
Last Name:UPADHYAY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4630 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:DEFOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-2828
Mailing Address - Country:US
Mailing Address - Phone:608-255-9119
Mailing Address - Fax:888-251-2784
Practice Address - Street 1:2010 EASTWOOD DR STE 202
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5387
Practice Address - Country:US
Practice Address - Phone:608-255-9119
Practice Address - Fax:888-251-2784
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2553-57103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical