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Organization

WENDY FADER PHD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDY FADER PHD PA (PRES PSYCHOLOGIST)
(561) 362-5530
Entity
Organization

Contact information

Practice address
5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL 33486-1080
(561) 362-5530
(561) 362-5595
Mailing address
5295 TOWN CENTER RD, SUITE 401, BOCA RATON, FL 33486-1080
(561) 362-5530
(561) 362-5595

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY004599
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
73916
BCBS FL
FL
Enumeration date
08/28/2006
Last updated
01/06/2010
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