Provider Demographics
NPI:1730372202
Name:WENDY FERRARA, MA, CCC-SLP
Entity type:Organization
Organization Name:WENDY FERRARA, MA, CCC-SLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:919-523-2154
Mailing Address - Street 1:2010 CEDAR GROVE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9372
Mailing Address - Country:US
Mailing Address - Phone:919-523-2154
Mailing Address - Fax:919-361-9188
Practice Address - Street 1:2010 CEDAR GROVE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9372
Practice Address - Country:US
Practice Address - Phone:919-523-2154
Practice Address - Fax:919-361-9188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-19
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC018AHOtherBLUE CROSS BLUE SHIELD OF NC
NC7200117Medicaid