| Doctor Name: | MS. WENDY FREDERICKSON TRUDEAU |
| NPI Number: | 1174585988 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 16060-130 |
| Business Practice Address: | 926 S 8th St Manitowoc, WI - 542204535 |
| Business Phone Number: | 9206834230 |
| Business Fax Number: | 9206834672 |
| Mailing Address: | 926 S 8th St, MANITOWOC |
| State: | WI |
| Postal Code: | 542204535 |
| Phone Number: | 9206834230 |
| Fax Number: | 9206834672 |
| NPI Enumeration Date: | 04/05/2006 |
| NPI Last Update Date: | 04/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 16060-130 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |