Provider Demographics
NPI:1821866013
Name:HENDY, CLARA WYATT (PA)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:WYATT
Last Name:HENDY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9559 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7001
Mailing Address - Country:US
Mailing Address - Phone:513-410-4486
Mailing Address - Fax:
Practice Address - Street 1:9559 COOPER LN
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-7001
Practice Address - Country:US
Practice Address - Phone:513-410-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program