Provider Demographics
NPI:1760498729
Name:HALSEY-RICHARDSON, WENDY M (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:M
Last Name:HALSEY-RICHARDSON
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9298 APISON PIKE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-9298
Mailing Address - Country:US
Mailing Address - Phone:423-648-4232
Mailing Address - Fax:423-622-5167
Practice Address - Street 1:9298 APISON PIKE
Practice Address - Street 2:SUITE 110
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-1240
Practice Address - Country:US
Practice Address - Phone:423-648-4232
Practice Address - Fax:423-622-5167
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN01046237600000X
GAAUD003608237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4640001OtherUNITEDHEALTH CARE