Healthcare Provider Details

I. General information

NPI: 1164340857
Provider Name (Legal Business Name): MRS. WENDY MARIE BUMBICO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 GREENGLADE AVE
WORTHINGTON OH
43085-2223
US

IV. Provider business mailing address

330 GREENGLADE AVE
WORTHINGTON OH
43085-2223
US

V. Phone/Fax

Practice location:
  • Phone: 614-893-3385
  • Fax:
Mailing address:
  • Phone: 614-893-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License NumberOH1273821
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: