Provider Demographics
NPI:1023215753
Name:FREE, WENDY BALL (OTR L)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:BALL
Last Name:FREE
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 PILSDON CRST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3821
Mailing Address - Country:US
Mailing Address - Phone:843-323-2103
Mailing Address - Fax:
Practice Address - Street 1:1308 PILSDON CRST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3821
Practice Address - Country:US
Practice Address - Phone:843-323-2103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1872225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics