Provider Demographics
NPI:1699989558
Name:CORREA, WENDY C O (OTR)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:C O
Last Name:CORREA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:CHIYO OHATA
Other - Last Name:CORREA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1304B AINAOLA DR
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-959-9739
Mailing Address - Fax:
Practice Address - Street 1:49 KAIULANI ST
Practice Address - Street 2:EASTER SEALS HAWAII HEIP
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-961-3081
Practice Address - Fax:808-961-6847
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist