Basic Information
| Provider Information | |||||||||
| NPI: | 1447604939 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOLB | ||||||||
| FirstName: | WENDY | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 165 E CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | BECHTELSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 195059778 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849487482 | ||||||||
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| Practice Location | |||||||||
| Address1: | 235 W LANCASTER AVE | ||||||||
| Address2: | |||||||||
| City: | DEVON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193331560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106888080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2016 | ||||||||
| LastUpdateDate: | 04/20/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OP002751L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.