Individual
WENDY GRACE MATLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6805 SYLVANIA AVE, SYLVANIA, OH 43560-3683
(419) 882-0029
Mailing address
1403 OWEN RD, NORTHWOOD, OH 43619-2222
(419) 367-7389
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007635
OH
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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