Provider Demographics
NPI:1629628078
Name:ARSENEAULT, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:ARSENEAULT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34788-2773
Mailing Address - Country:US
Mailing Address - Phone:352-527-9195
Mailing Address - Fax:
Practice Address - Street 1:106 MELODY LN
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34788-2773
Practice Address - Country:US
Practice Address - Phone:352-527-9195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider