Provider Demographics
NPI:1164482642
Name:FINE-THOMAS, WENDY (PHD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:FINE-THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13917 QUAIL POINTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134
Mailing Address - Country:US
Mailing Address - Phone:405-748-6500
Mailing Address - Fax:405-748-6504
Practice Address - Street 1:13917 QUAIL POINTE DRIVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1002
Practice Address - Country:US
Practice Address - Phone:405-748-6500
Practice Address - Fax:405-748-6504
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK887103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical