Healthcare Provider Details

I. General information

NPI: 1508217019
Provider Name (Legal Business Name): WENDY MEILEING PARKER BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 E HURON AVE
BAD AXE MI
48413-1314
US

IV. Provider business mailing address

181 E HURON AVE
BAD AXE MI
48413-1314
US

V. Phone/Fax

Practice location:
  • Phone: 810-214-2641
  • Fax: 810-412-6232
Mailing address:
  • Phone: 810-214-2641
  • Fax: 810-412-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-16-7165
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: