Pethybridge, Wendy
Pethybridge, Wendy is an sole proprietor health care provider with primary practice located at 4200 N Pebble Creek Pkwy Apt 2127 , Goodyear AZ 85395-9037. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Pethybridge, Wendy can be contacted via phone (253) 257-5177.Contact Information
Primary practice address
4200 N Pebble Creek Pkwy Apt 2127
Goodyear AZ 85395-9037
Phone: (253) 257-5177
Fax: (315) 546-2406
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1073052908 |
|---|---|
| LBN Legal business name | Pethybridge, Wendy |
| Credentials | MA, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 12th, 2017 |
| Last updated | Mar 27th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073052908 | NPPES |
| Washington | MEDICAID | 2176663 |
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