Provider Demographics
NPI:1033276191
Name:SAWICKI, WENDY L (OTR)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:SAWICKI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 143
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-0143
Mailing Address - Country:US
Mailing Address - Phone:207-318-1425
Mailing Address - Fax:
Practice Address - Street 1:688 ROUTE 1
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6995
Practice Address - Country:US
Practice Address - Phone:207-318-1425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT774225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMN0281OtherMEDICAL NETWORK
ME033306OtherANTHEM BLUE CROSS