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General NPI Number Information
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NPI Number | 1982807509
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Entity Type | Individual
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Provider Name | WENDI LEA BOETTCHER ATR-BC, LCAT
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Gender | Female
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Dates
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Enumeration Date | 06/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 425 ROBINSON ST
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City | BINGHAMTON
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State | NY
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Zip | 13904-1735
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Country | US
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Telephone | 607-773-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 39 ROBERTS ST
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City | KIRKWOOD
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State | NY
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Zip | 13795-1018
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Country | US
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Telephone | 607-775-0808
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Fax |
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 000933-1
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License Number State | NY
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