Provider Demographics
NPI:1740362995
Name:MACNEILL, WENDY SUZANNE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SUZANNE
Last Name:MACNEILL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUZANNE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13919 W 71ST PL
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-5502
Mailing Address - Country:US
Mailing Address - Phone:816-665-8137
Mailing Address - Fax:
Practice Address - Street 1:8823 PRODUCTION LN
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6511
Practice Address - Country:US
Practice Address - Phone:423-238-7217
Practice Address - Fax:423-238-3473
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004553225XH1200X
KS17-01687225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand