Provider Demographics
NPI:1841316056
Name:LI, WENJING (OTR L)
Entity type:Individual
Prefix:
First Name:WENJING
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VILLAGE HILL LN APT 24
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-5725
Mailing Address - Country:US
Mailing Address - Phone:617-515-9519
Mailing Address - Fax:
Practice Address - Street 1:30 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4938
Practice Address - Country:US
Practice Address - Phone:617-734-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8769225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist