Provider Demographics
NPI:1629384227
Name:WENDY BUCKELS & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:WENDY BUCKELS & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BUCKELS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:505-610-7020
Mailing Address - Street 1:1706 RIDGECREST DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4439
Mailing Address - Country:US
Mailing Address - Phone:505-610-7020
Mailing Address - Fax:505-255-4311
Practice Address - Street 1:1706 RIDGECREST DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-4439
Practice Address - Country:US
Practice Address - Phone:505-610-7020
Practice Address - Fax:505-255-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM914251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health