Provider Demographics
NPI:1417426560
Name:WILKINS, WENDY ANN (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:ANN
Last Name:WILKINS
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-1774
Mailing Address - Country:US
Mailing Address - Phone:814-726-3466
Mailing Address - Fax:814-726-1575
Practice Address - Street 1:404 MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-1774
Practice Address - Country:US
Practice Address - Phone:814-726-3466
Practice Address - Fax:814-726-1575
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF02811237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter