Provider Demographics
NPI:1780656140
Name:CAPLIN, WENDY ANN (PHD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ANN
Last Name:CAPLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 E DURHAM ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1222
Mailing Address - Country:US
Mailing Address - Phone:215-248-9446
Mailing Address - Fax:215-248-3704
Practice Address - Street 1:436 E DURHAM ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1222
Practice Address - Country:US
Practice Address - Phone:215-248-9446
Practice Address - Fax:215-248-3704
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005962L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA715420Medicare ID - Type Unspecified