Provider Demographics
NPI:1972979318
Name:WENDLING, REBECKA (BS)
Entity Type:Individual
Prefix:
First Name:REBECKA
Middle Name:
Last Name:WENDLING
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W CALHOUN
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-3508
Mailing Address - Country:US
Mailing Address - Phone:870-234-1597
Mailing Address - Fax:870-234-1791
Practice Address - Street 1:301 W CALHOUN
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-3508
Practice Address - Country:US
Practice Address - Phone:870-234-1597
Practice Address - Fax:870-234-1791
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist