Individual
WENDY LERNER ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 BRAGG ST, PEABODY, MA 01960-1413
(978) 532-8529
(978) 532-5522
Mailing address
4 BRAGG ST, PEABODY, MA 01960-1413
(978) 532-8529
(978) 532-5522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2885
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP0036
BCBS PROVIDER NUMBER
MA
Enumeration date
01/30/2007
Last updated
07/08/2007
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