Provider Demographics
NPI:1790827558
Name:DEUTSCH, WENDY ROBIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ROBIN
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 GAYLEY ST
Mailing Address - Street 2:C-407
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3766
Mailing Address - Country:US
Mailing Address - Phone:610-566-1920
Mailing Address - Fax:
Practice Address - Street 1:91 DOWLIN FORGE RD.
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19335
Practice Address - Country:US
Practice Address - Phone:610-280-9888
Practice Address - Fax:610-280-9788
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015301103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent