Provider Demographics
NPI:1477916377
Name:VESS, WENDY BYRUM
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:BYRUM
Last Name:VESS
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 1:475 TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3234
Mailing Address - Country:US
Mailing Address - Phone:321-525-1015
Mailing Address - Fax:
Practice Address - Street 1:475 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3234
Practice Address - Country:US
Practice Address - Phone:321-525-1015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor