Provider Demographics
NPI:1669662300
Name:TROUSDALE, WENDI LYN
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:LYN
Last Name:TROUSDALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:LYN
Other - Last Name:JOYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 406153
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-1876
Mailing Address - Country:US
Mailing Address - Phone:315-732-1512
Mailing Address - Fax:315-732-8919
Practice Address - Street 1:114 GENESEE ST
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2329
Practice Address - Country:US
Practice Address - Phone:315-732-1512
Practice Address - Fax:315-732-8919
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000014680237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist