Provider Demographics
NPI:1588833511
Name:WENZLER, MERISSA KAYE (OTD)
Entity Type:Individual
Prefix:MRS
First Name:MERISSA
Middle Name:KAYE
Last Name:WENZLER
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 WINDING WAY DR
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-9063
Mailing Address - Country:US
Mailing Address - Phone:615-672-1611
Mailing Address - Fax:
Practice Address - Street 1:370 OLD SHACKLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3082
Practice Address - Country:US
Practice Address - Phone:615-824-0720
Practice Address - Fax:615-824-0272
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-24
Last Update Date:2008-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3750225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist