Provider Demographics
NPI:1366503989
Name:LEMKE, WENDY KAY (MS)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:KAY
Last Name:LEMKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 CLEARWATER CENTER
Mailing Address - Street 2:P.O. 434
Mailing Address - City:CLEARWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55320
Mailing Address - Country:US
Mailing Address - Phone:320-558-6037
Mailing Address - Fax:
Practice Address - Street 1:810 CLEARWATER CENTER
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:MN
Practice Address - Zip Code:55320
Practice Address - Country:US
Practice Address - Phone:320-558-6037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2529103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling