Provider Demographics
NPI:1205961695
Name:OGIMOTO DANG, WENDY (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:
Last Name:OGIMOTO DANG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13219 N 80TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4903
Mailing Address - Country:US
Mailing Address - Phone:480-620-2313
Mailing Address - Fax:
Practice Address - Street 1:13219 N 80TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-4903
Practice Address - Country:US
Practice Address - Phone:480-620-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0361235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist