Provider Demographics
NPI:1376331843
Name:WYAND, DENA MARIE
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:MARIE
Last Name:WYAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1331
Mailing Address - Country:US
Mailing Address - Phone:805-524-8476
Mailing Address - Fax:805-524-6121
Practice Address - Street 1:555 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015-1331
Practice Address - Country:US
Practice Address - Phone:805-524-8476
Practice Address - Fax:808-524-6121
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220062889101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool