Provider Demographics
NPI:1952554750
Name:ZEBALLOS, WENDY R
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:R
Last Name:ZEBALLOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1557 PINE MARSH LOOP
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771
Mailing Address - Country:US
Mailing Address - Phone:407-242-4320
Mailing Address - Fax:
Practice Address - Street 1:1557 PINE MARSH LOOP
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-7407
Practice Address - Country:US
Practice Address - Phone:407-242-5320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst