Provider Demographics
NPI:1376717173
Name:DAVIS, WENDY CHRISTIAN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:CHRISTIAN
Last Name:DAVIS
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 1:2728 WARREN BURTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44470-9742
Mailing Address - Country:US
Mailing Address - Phone:330-898-9147
Mailing Address - Fax:330-898-9147
Practice Address - Street 1:2728 WARREN BURTON RD
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:44470-9742
Practice Address - Country:US
Practice Address - Phone:330-898-9147
Practice Address - Fax:330-898-9147
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02445225XR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community Mobility