Provider Demographics
NPI:1124911680
Name:WENK, MAURA
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:WENK
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 1:1 LONGFELLOW PL APT 3021
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2428
Mailing Address - Country:US
Mailing Address - Phone:937-776-7008
Mailing Address - Fax:
Practice Address - Street 1:1 LONGFELLOW PL APT 3021
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2428
Practice Address - Country:US
Practice Address - Phone:937-776-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical