Provider Demographics
NPI:1447479522
Name:LOOMANS, WENDY JEAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:JEAN
Last Name:LOOMANS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 102ND ST W
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55077-4730
Mailing Address - Country:US
Mailing Address - Phone:612-730-5315
Mailing Address - Fax:
Practice Address - Street 1:1441 102ND ST W
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55077-4730
Practice Address - Country:US
Practice Address - Phone:612-730-5315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4802103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical