Provider Demographics
NPI:1225317746
Name:COTTRELL, WENDY MICHELLE
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:MICHELLE
Last Name:COTTRELL
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 1:1980 PARK LN W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-7830
Mailing Address - Country:US
Mailing Address - Phone:801-225-0588
Mailing Address - Fax:
Practice Address - Street 1:1980 PARK LN W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-7830
Practice Address - Country:US
Practice Address - Phone:801-225-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical