Provider Demographics
NPI:1770709503
Name:LAURENZI, WENDY MARIE (MA, LSE)
Entity type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:MARIE
Last Name:LAURENZI
Suffix:
Gender:F
Credentials:MA, LSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1037
Mailing Address - Country:US
Mailing Address - Phone:330-744-2991
Mailing Address - Fax:330-744-2971
Practice Address - Street 1:611 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1037
Practice Address - Country:US
Practice Address - Phone:330-744-2991
Practice Address - Fax:330-744-2971
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS16782104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker