Provider Demographics
NPI:1982631354
Name:LOVE, WENDY R (OT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:R
Last Name:LOVE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5047 DUNSHA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8483
Mailing Address - Country:US
Mailing Address - Phone:330-239-4491
Mailing Address - Fax:330-239-4490
Practice Address - Street 1:5047 DUNSHA RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8483
Practice Address - Country:US
Practice Address - Phone:330-239-4491
Practice Address - Fax:330-239-4490
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT006585225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist