Provider Demographics
NPI:1235324146
Name:WILKES, WENDY (MA CFY-SLP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:WILKES
Suffix:
Gender:F
Credentials:MA CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4617 TIFFANY WOODS CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6102
Mailing Address - Country:US
Mailing Address - Phone:727-698-1889
Mailing Address - Fax:
Practice Address - Street 1:4617 TIFFANY WOODS CIR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6102
Practice Address - Country:US
Practice Address - Phone:727-698-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist