Provider Demographics
NPI:1164134888
Name:ROSARIO, WENDY HERRERA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:HERRERA
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:MAYOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:1335 STRASSNER DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1872
Mailing Address - Country:US
Mailing Address - Phone:877-367-9772
Mailing Address - Fax:
Practice Address - Street 1:8785 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33467-2433
Practice Address - Country:US
Practice Address - Phone:877-367-9772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23724225X00000X
OT23724225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist