Provider Demographics
NPI:1164413043
Name:FERRARA, WENDY A (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:A
Last Name:FERRARA
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PLANO DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7870
Mailing Address - Country:US
Mailing Address - Phone:919-523-2154
Mailing Address - Fax:919-361-9188
Practice Address - Street 1:111 PLANO DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-7870
Practice Address - Country:US
Practice Address - Phone:919-523-2154
Practice Address - Fax:919-361-9188
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412411Medicaid