Individual
MRS. WENDY RENE' KACZYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4620 CEDAR AVE, SUITE 118, WILMINGTON, NC 28403-4424
(910) 790-5150
(910) 790-9011
Mailing address
5616 MAXWELL PL, WILMINGTON, NC 28409-2966
(910) 793-9996
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301324B
—
NC
Enumeration date
11/09/2007
Last updated
11/09/2007
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