Provider Demographics
NPI:1568625887
Name:HART, WENDY L (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:L
Last Name:HART
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BIRD LN
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5001
Mailing Address - Country:US
Mailing Address - Phone:914-475-2595
Mailing Address - Fax:845-463-1419
Practice Address - Street 1:5 BIRD LN
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5001
Practice Address - Country:US
Practice Address - Phone:914-475-2595
Practice Address - Fax:845-463-1419
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006848-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist