Provider Demographics
NPI:1942361043
Name:LIPSCOMB, WENDY CAROLYN (MS,OT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:CAROLYN
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:MS,OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2970
Mailing Address - Country:US
Mailing Address - Phone:334-677-3331
Mailing Address - Fax:
Practice Address - Street 1:215 WESTBROOK RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2970
Practice Address - Country:US
Practice Address - Phone:334-677-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2248225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist