Provider Demographics
NPI:1174606842
Name:POLSKY, WENDY RUTH (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:RUTH
Last Name:POLSKY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:WENDY
Other - Middle Name:POLSKY
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3909 OAKMONT CIR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-3309
Mailing Address - Country:US
Mailing Address - Phone:931-265-7225
Mailing Address - Fax:
Practice Address - Street 1:215 WEST 8TH STREET
Practice Address - Street 2:COOKEVILLE REGIONAL MEDICAL CENTER
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-783-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1781OtherLICENSE NUMBER