Provider Demographics
NPI:1235337866
Name:YOST, WENDY BERTGES (PHD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:BERTGES
Last Name:YOST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:MARIE
Other - Last Name:BERTGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22146 BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3816
Mailing Address - Country:US
Mailing Address - Phone:586-778-6631
Mailing Address - Fax:
Practice Address - Street 1:42633 GARFIELD RD
Practice Address - Street 2:SUITE 314
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5033
Practice Address - Country:US
Practice Address - Phone:586-226-7007
Practice Address - Fax:586-226-7033
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical