Healthcare Provider Details

I. General information

NPI: 1679260848
Provider Name (Legal Business Name): WENDY RENEE KENNEDY OTR/L, CHT, CFNC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WENDY DAGUE

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 KENT DR
DOYLESTOWN PA
18902-6630
US

IV. Provider business mailing address

2720 KENT DR
DOYLESTOWN PA
18902-6630
US

V. Phone/Fax

Practice location:
  • Phone: 215-534-2156
  • Fax:
Mailing address:
  • Phone: 215-534-2156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC003783L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: