Provider Demographics
NPI:1922364728
Name:HENDLEY, VANESSA WETSEL (NTP, LMT)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:WETSEL
Last Name:HENDLEY
Suffix:
Gender:F
Credentials:NTP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280A ELIZABETH KAY LANE
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9544
Mailing Address - Country:US
Mailing Address - Phone:304-549-3373
Mailing Address - Fax:
Practice Address - Street 1:280A ELIZABETH KAY LANE
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9544
Practice Address - Country:US
Practice Address - Phone:304-549-3373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2004-1446174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
621399OtherNAICS