MEDICARE: WENDI LYN HAYDEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	9127605-3502

General Provider Information

NPI Number	:	1124364013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDI LYN HAYDEN

Provider Business Mailing Address
First Line	:	4640 S 3500 W STE 4
Second Line	:
City	:	WEST HAVEN
State	:	UT
Zip	:	84401-6522
Country	:	US
Telephone Number	:	801-603-4792
Fax Number	:

Provider Business Practice Location Address
First Line	:	4640 S 3500 W STE 4
Second Line	:
City	:	WEST HAVEN
State	:	UT
Zip	:	84401-6522
Country	:	US
Telephone Number	:	801-603-4792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2012
Last Update Date	:	10/16/2024

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Directions to “ WENDI LYN HAYDEN ” Practice Location

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