Provider Demographics
NPI:1154053601
Name:WENTLAND, SADIE N
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:N
Last Name:WENTLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1142
Mailing Address - Country:US
Mailing Address - Phone:717-632-8400
Mailing Address - Fax:
Practice Address - Street 1:100 W EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1142
Practice Address - Country:US
Practice Address - Phone:717-632-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool