Provider Demographics
NPI:1487027611
Name:HEATH-WIRTZ, WENDY (MS, NCC, QMHP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:HEATH-WIRTZ
Suffix:
Gender:F
Credentials:MS, NCC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19811 GALILEO AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2881
Mailing Address - Country:US
Mailing Address - Phone:541-306-9700
Mailing Address - Fax:
Practice Address - Street 1:371 SW UPPER TERRACE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1560
Practice Address - Country:US
Practice Address - Phone:541-617-0377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health