Provider Demographics
NPI:1467020065
Name:FAILOR, WENDY W (MACMHC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:W
Last Name:FAILOR
Suffix:
Gender:F
Credentials:MACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 CUMBERLAND BLVD SE APT 216
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-2842
Mailing Address - Country:US
Mailing Address - Phone:912-547-9302
Mailing Address - Fax:
Practice Address - Street 1:2230 TOWNE LAKE PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5540
Practice Address - Country:US
Practice Address - Phone:678-631-7639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health