Provider Demographics
NPI:1578506713
Name:ALTON, WENDY A (PHD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:ALTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 EAST IRON
Mailing Address - Street 2:SUITE D
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-7405
Mailing Address - Country:US
Mailing Address - Phone:785-827-2600
Mailing Address - Fax:785-309-0184
Practice Address - Street 1:645 EAST IRON
Practice Address - Street 2:SUITE D
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-7405
Practice Address - Country:US
Practice Address - Phone:785-827-2600
Practice Address - Fax:785-309-0184
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP 0930103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060749OtherBLUE CROSS BLUE SHIELD
KS245713OtherMANAGED HEALTH NETWORK
KS100097970AMedicaid
KS1036333OtherCIGNA
KS245713OtherMANAGED HEALTH NETWORK