Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MRS. MATTRACEA WENDLETON
Active
Individual
MRS. MATTRACEA WENDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2017037738
MO
172V00000X
Community Health Worker
—
—
Other
Enumeration date
10/29/2014
Last updated
05/03/2021
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