Provider Demographics
NPI:1578286464
Name:WATERMAN, WENDY JANE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:JANE
Last Name:WATERMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JANE
Other - Last Name:DEBAPTISTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1530 VIA DE PEPI
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8240
Mailing Address - Country:US
Mailing Address - Phone:561-573-9909
Mailing Address - Fax:
Practice Address - Street 1:1530 VIA DE PEPI
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8240
Practice Address - Country:US
Practice Address - Phone:561-573-9909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist