Provider Demographics
NPI:1447313275
Name:ISAAC, WENDY LYNN (BS)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:ISAAC
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 PONDEROSA WAY APT C
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-4152
Mailing Address - Country:US
Mailing Address - Phone:307-352-6677
Mailing Address - Fax:
Practice Address - Street 1:1021 PONDEROSA WAY APT C
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4152
Practice Address - Country:US
Practice Address - Phone:307-352-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)