Provider Demographics
NPI:1508217019
Name:PARKER, WENDY MEILEING (BCABA)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:MEILEING
Last Name:PARKER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 GARFIELD WOODS DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5160
Mailing Address - Country:US
Mailing Address - Phone:231-668-4909
Mailing Address - Fax:231-943-1334
Practice Address - Street 1:990 GARFIELD WOODS DR
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5160
Practice Address - Country:US
Practice Address - Phone:231-668-4909
Practice Address - Fax:231-943-1334
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0-16-7165103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst