Provider Demographics
NPI:1679260848
Name:KENNEDY, WENDY RENEE (OTR/L, CHT, CFNC)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:RENEE
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:OTR/L, CHT, CFNC
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:DAGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2720 KENT DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-6630
Mailing Address - Country:US
Mailing Address - Phone:215-534-2156
Mailing Address - Fax:
Practice Address - Street 1:2720 KENT DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-6630
Practice Address - Country:US
Practice Address - Phone:215-534-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
PAOC003783L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174H00000XOther Service ProvidersHealth Educator