Healthcare Provider Details

I. General information

NPI: 1699601054
Provider Name (Legal Business Name): WENDI SMITH STITT PALOMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDI MICHELLE LEWIS RMA

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 E ROUTT AVE
PUEBLO CO
81004-2122
US

IV. Provider business mailing address

2002 CHISM DR
PUEBLO CO
81008-1868
US

V. Phone/Fax

Practice location:
  • Phone: 719-357-4066
  • Fax:
Mailing address:
  • Phone: 719-357-4066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: