Provider Demographics
NPI:1023715950
Name:WENDE, HEATHER QUINN (APSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:QUINN
Last Name:WENDE
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 MONONA DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-3556
Mailing Address - Country:US
Mailing Address - Phone:608-286-1132
Mailing Address - Fax:
Practice Address - Street 1:5900 MONONA DR STE 102
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3556
Practice Address - Country:US
Practice Address - Phone:608-286-1132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2093-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker