Provider Demographics
NPI:1770610446
Name:CARPENTER, WENDY N (PHD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:N
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 RIO GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHILI
Mailing Address - State:NY
Mailing Address - Zip Code:14514-9780
Mailing Address - Country:US
Mailing Address - Phone:585-241-1557
Mailing Address - Fax:
Practice Address - Street 1:620 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4610
Practice Address - Country:US
Practice Address - Phone:585-461-8743
Practice Address - Fax:585-461-8545
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016393-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist