Provider Demographics
NPI:1649705963
Name:DAMMAI, WENDY MORGAN (ATC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MORGAN
Last Name:DAMMAI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HARBOR COVE LN APT 1400F
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3013
Mailing Address - Country:US
Mailing Address - Phone:843-697-9947
Mailing Address - Fax:
Practice Address - Street 1:172 RUTLEDGE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5821
Practice Address - Country:US
Practice Address - Phone:843-697-9947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6802255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer