Provider Demographics
NPI:1275184046
Name:DIPHILLIPO, WENDY MARIE (BA)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:MARIE
Last Name:DIPHILLIPO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ARLINGTON TER
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-7610
Mailing Address - Country:US
Mailing Address - Phone:617-771-3691
Mailing Address - Fax:
Practice Address - Street 1:7 ARLINGTON TER
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-7610
Practice Address - Country:US
Practice Address - Phone:617-771-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty