Provider Demographics
NPI:1922272210
Name:EVINS, WENDY K (AUD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:K
Last Name:EVINS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:K
Other - Last Name:STICKNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2510 E SUNSET RD
Mailing Address - Street 2:SUITE #5-260
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3511
Mailing Address - Country:US
Mailing Address - Phone:702-798-0113
Mailing Address - Fax:866-291-5242
Practice Address - Street 1:820 E MATTHEWS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3048
Practice Address - Country:US
Practice Address - Phone:870-268-1488
Practice Address - Fax:870-268-1613
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#247231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist