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NPI Code Detail

MEDICARE: WENDY ALLEN OTR/L

MEDICARE: WENDY ALLEN OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1193MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043202310
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY ALLEN OTR/L
Provider Business Mailing Address
First Line : 1029A HIGHWAY 42
Second Line :
City : PETAL
State : MS
Zip : 39465-9768
Country : US
Telephone Number : 662-241-4545
Fax Number : 662-241-4025
Provider Business Practice Location Address
First Line : 65 DUTCH LN
Second Line :
City : COLUMBUS
State : MS
Zip : 39702-5523
Country : US
Telephone Number : 662-241-4545
Fax Number : 662-241-4025
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 11/08/2010

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Directions to “ WENDY ALLEN OTR/L” Practice Location

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