Provider Demographics
NPI:1063892719
Name:HANDLEY, GWENDOLENE SHARON (OT)
Entity type:Individual
Prefix:MRS
First Name:GWENDOLENE
Middle Name:SHARON
Last Name:HANDLEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DE BARTOLO PLACE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512
Mailing Address - Country:US
Mailing Address - Phone:330-965-7828
Mailing Address - Fax:
Practice Address - Street 1:100 DEBARTOLO PL
Practice Address - Street 2:SUITE 220
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-7011
Practice Address - Country:US
Practice Address - Phone:330-965-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 003529174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist