Provider Demographics
NPI:1255730263
Name:WENDT, AMIRA (SLP)
Entity type:Individual
Prefix:MRS
First Name:AMIRA
Middle Name:
Last Name:WENDT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 ORRCREST DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-8008
Mailing Address - Country:US
Mailing Address - Phone:775-846-9652
Mailing Address - Fax:
Practice Address - Street 1:262 ORRCREST DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-8008
Practice Address - Country:US
Practice Address - Phone:775-846-9652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist