Provider Demographics
NPI:1336325588
Name:WENDEL, MARK G (MA)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:G
Last Name:WENDEL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WOODS LN
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-9400
Mailing Address - Country:US
Mailing Address - Phone:814-941-4661
Mailing Address - Fax:
Practice Address - Street 1:500 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-5215
Practice Address - Country:US
Practice Address - Phone:814-946-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor