Individual
MS. WENDY I WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
229 W SPRING ST, NEW ALBANY, IN 47150-3641
(812) 206-3291
(812) 206-3296
Mailing address
PO BOX 413, NEW ALBANY, IN 47151-0413
(812) 206-3291
(812) 206-3296
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1650
KY
104100000X
Social Worker
Primary
34004562
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160860U
MEDICARE
IN
05
—
8200051400
—
KY
Enumeration date
06/24/2005
Last updated
07/08/2007
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