Healthcare Provider Details

I. General information

NPI: 1104610161
Provider Name (Legal Business Name): WENDY WELLES LANXNER LPMT, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 TUCKERMAN LN
NORTH BETHESDA MD
20852-3385
US

IV. Provider business mailing address

620 WOODSIDE PKWY
SILVER SPRING MD
20910-4248
US

V. Phone/Fax

Practice location:
  • Phone: 202-686-8000
  • Fax:
Mailing address:
  • Phone: 240-893-0480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number00191
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: