Provider Demographics
NPI:1508096058
Name:FEBRUARY-WENDT, MICHELE C (OT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:C
Last Name:FEBRUARY-WENDT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:C
Other - Last Name:FEBRUARY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9576 CANTERBURY RIDING
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1415
Mailing Address - Country:US
Mailing Address - Phone:240-533-2341
Mailing Address - Fax:301-317-1969
Practice Address - Street 1:3115 FALLSTON AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3403
Practice Address - Country:US
Practice Address - Phone:240-533-2341
Practice Address - Fax:301-317-1969
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05494174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD05494OtherLICENSE