Provider Demographics
NPI:1134497225
Name:TOWNSEND IRWIN, WENDY ANN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:ANN
Last Name:TOWNSEND IRWIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:IRWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3665 SAINT PAUL BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-2731
Mailing Address - Country:US
Mailing Address - Phone:585-330-6041
Mailing Address - Fax:
Practice Address - Street 1:690 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-1709
Practice Address - Country:US
Practice Address - Phone:585-330-6041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9790-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist