Provider Demographics
NPI:1497169825
Name:CANOVA, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CANOVA
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 1:1034 W 360 S
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3328
Mailing Address - Country:US
Mailing Address - Phone:801-791-4247
Mailing Address - Fax:
Practice Address - Street 1:1447 S 550 E
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-7136
Practice Address - Country:US
Practice Address - Phone:801-901-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical