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General NPI Number Information
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NPI Number | 1093904138
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Entity Type | Individual
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Provider Name | WENDI WOODS MULLIGAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 17720 LARGO PLACE
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City | CORNELIUS
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State | NC
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Zip | 28031
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Country | US
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Telephone | 413-335-5343
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Fax | 704-459-5074
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Provider Business Mailing Address
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Address Line | 20311 CHARTWELL CENTER DRIVE P.O. BOX 2012
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City | CORNELIUS
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State | NC
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Zip | 28031
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Country | US
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Telephone | 413-335-5343
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Fax | 704-459-5074
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 9238
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License Number State | MA
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