Provider Demographics
NPI:1689956849
Name:HAYNES, WENDY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:HAYNES
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 1:284 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-9753
Mailing Address - Country:US
Mailing Address - Phone:585-335-4030
Mailing Address - Fax:585-335-4056
Practice Address - Street 1:284 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9753
Practice Address - Country:US
Practice Address - Phone:585-335-4030
Practice Address - Fax:585-335-4056
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021176-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist