Provider Demographics
NPI:1831190677
Name:KLINE, WENDY LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LYNN
Last Name:KLINE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:LYNN
Other - Last Name:DRAKE-KLINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:940 DEER RUN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-6103
Mailing Address - Country:US
Mailing Address - Phone:937-602-0567
Mailing Address - Fax:937-813-8168
Practice Address - Street 1:940 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-6103
Practice Address - Country:US
Practice Address - Phone:937-602-0567
Practice Address - Fax:937-813-8168
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000024225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000029657OtherOCCUPATIONAL THERAPIST
OH2827043Medicaid
OH0732331Medicare PIN