Individual
MRS. WENDY RENEE BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7631 LAKERIDGE DR, FORT WAYNE, IN 46819-1969
(260) 415-8526
Mailing address
7631 LAKERIDGE DR, FORT WAYNE, IN 46819-1969
(260) 415-8526
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/16/2015
Last updated
12/16/2015
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