Provider Demographics
NPI:1619056611
Name:RICE, WENDY B (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:B
Last Name:RICE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14310 N DALE MABRY HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2050
Mailing Address - Country:US
Mailing Address - Phone:813-969-3878
Mailing Address - Fax:813-969-3887
Practice Address - Street 1:14310 N DALE MABRY HWY STE 150
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-969-3878
Practice Address - Fax:813-969-3887
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6382103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist