Provider Demographics
NPI:1881236396
Name:MCGINNIS, WENDY JANE (PHD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:JANE
Last Name:MCGINNIS
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 1:11506 S-23 HWY.
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125
Mailing Address - Country:US
Mailing Address - Phone:515-480-5713
Mailing Address - Fax:
Practice Address - Street 1:2500 82ND PL
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4329
Practice Address - Country:US
Practice Address - Phone:515-412-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086690103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty