Provider Demographics
NPI:1104900976
Name:GREENE, WENDY (OTR/L)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:GREENE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20501 QUIET VALLEY CT # 201
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3185
Mailing Address - Country:US
Mailing Address - Phone:404-093-7362
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:20501 QUIET VALLEY CT # 201
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3185
Practice Address - Country:US
Practice Address - Phone:404-093-7362
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02538225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist