| Doctor Name: | MS. WENDY BEVAN |
| NPI Number: | 1174864292 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 013623 |
| Business Practice Address: | 1118 Charles St Elmira, NY - 149042709 |
| Business Phone Number: | 6077347107 |
| Business Fax Number: | 6077347334 |
| Mailing Address: | 1118 Charles St, ELMIRA |
| State: | NY |
| Postal Code: | 149042709 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2013 |
| NPI Last Update Date: | 03/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 013623 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |