Basic Information
| Provider Information | |||||||||
| NPI: | 1922480185 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARRETT | ||||||||
| FirstName: | WENDY | ||||||||
| MiddleName: | JO | ||||||||
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| Credential: | NP, PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 259 MONROE AVE. | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146073632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855457200 | ||||||||
| FaxNumber: | 5852446456 | ||||||||
| Practice Location | |||||||||
| Address1: | 259 MONROE AVE. | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146073632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855457200 | ||||||||
| FaxNumber: | 5859787217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2015 | ||||||||
| LastUpdateDate: | 06/02/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 571391 | NY | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 364SP0810X | F401888 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Child & Family |
No ID Information.