Individual
MARK WENDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, MA, MAC
Contact information
Practice address
13838 BOYTER LN, VIVIAN, LA 71082-9788
(318) 519-9034
(318) 375-2643
Mailing address
13838 BOYTER LN, VIVIAN, LA 71082-9788
(318) 519-9034
(318) 375-2643
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4798
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4798
STATE BOARD
LA
Enumeration date
12/14/2019
Last updated
12/14/2019
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