Individual
MRS. WENDY NIVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
267 FREDERICK ST, HANOVER, PA 17331-3614
(717) 633-4535
Mailing address
849 FUHRMAN MILL RD, HANOVER, PA 17331-9311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP007933
PA
Other
Enumeration date
01/18/2019
Last updated
03/30/2020
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