Provider Demographics
NPI:1700197712
Name:WENZ, REBEKAH RUTH (MSED, BSST)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:RUTH
Last Name:WENZ
Suffix:
Gender:F
Credentials:MSED, BSST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6690 FOX RD
Mailing Address - Street 2:
Mailing Address - City:MARCY
Mailing Address - State:NY
Mailing Address - Zip Code:13403-3218
Mailing Address - Country:US
Mailing Address - Phone:315-525-2009
Mailing Address - Fax:
Practice Address - Street 1:1601 ARMORY DR
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5405
Practice Address - Country:US
Practice Address - Phone:315-798-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant