Healthcare Provider Details

I. General information

NPI: 1881663268
Provider Name (Legal Business Name): WENDY COHEN-SLATE OTRL CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 PALMER AVE UNIT 2
FALMOUTH MA
02540
US

IV. Provider business mailing address

620 PALMER AVE UNIT 2
FALMOUTH MA
02540-5103
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-5559
  • Fax: 508-540-5660
Mailing address:
  • Phone: 508-540-5559
  • Fax: 508-540-5660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number5622
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: