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NPI Code Detail

MEDICARE: STEPHEN WEN

MEDICARE: STEPHEN WEN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1922801430
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN WEN
Provider Business Mailing Address
First Line : 382 NE 191ST ST STE 98090
Second Line :
City : MIAMI
State : FL
Zip : 33179-3899
Country : US
Telephone Number : 612-201-2468
Fax Number : 919-561-6112
Provider Business Practice Location Address
First Line : 2080 WOODDALE DR STE 200
Second Line :
City : WOODBURY
State : MN
Zip : 55125-2920
Country : US
Telephone Number : 612-201-2468
Fax Number : 919-561-6111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2025
Last Update Date : 03/31/2025

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Directions to “ STEPHEN WEN ” Practice Location

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