Provider Demographics
NPI:1598048530
Name:BARRICK, WENDY LAURA (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LAURA
Last Name:BARRICK
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 1:460 BOHEMIA PKWY
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-3302
Mailing Address - Country:US
Mailing Address - Phone:631-563-4156
Mailing Address - Fax:
Practice Address - Street 1:320 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-2043
Practice Address - Country:US
Practice Address - Phone:631-244-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4196235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist