Provider Demographics
NPI:1780126854
Name:WENDT, JULIE (LDN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:WENDT
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 FERNDALE ST
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2754
Mailing Address - Country:US
Mailing Address - Phone:301-448-5804
Mailing Address - Fax:
Practice Address - Street 1:3109 FERNDALE ST
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2754
Practice Address - Country:US
Practice Address - Phone:301-448-5804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3785133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education