Provider Demographics
NPI:1225303688
Name:HENNER, WENDY LEE (MA ABS)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:LEE
Last Name:HENNER
Suffix:
Gender:F
Credentials:MA ABS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7872
Mailing Address - Country:US
Mailing Address - Phone:503-420-6760
Mailing Address - Fax:
Practice Address - Street 1:603 E 2ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7872
Practice Address - Country:US
Practice Address - Phone:034-206-7605
Practice Address - Fax:520-727-7536
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst