Provider Demographics
NPI:1275109472
Name:WENDT, BROOKLYN EILEEN (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:EILEEN
Last Name:WENDT
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANITA
Mailing Address - State:IA
Mailing Address - Zip Code:50020-1033
Mailing Address - Country:US
Mailing Address - Phone:712-249-8218
Mailing Address - Fax:
Practice Address - Street 1:2401 E 8TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-1717
Practice Address - Country:US
Practice Address - Phone:828-297-6452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist