Provider Demographics
NPI:1013072875
Name:WENZEL, AMY ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:WENZEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:217 WALNUT PL
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-5710
Mailing Address - Country:US
Mailing Address - Phone:267-746-0566
Mailing Address - Fax:484-454-3110
Practice Address - Street 1:1062 E LANCASTER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1552
Practice Address - Country:US
Practice Address - Phone:267-746-0566
Practice Address - Fax:484-454-3110
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015680103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical