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Individual

MRS. WENDALYN WEAVER BATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
112 WIGMORE CT, SAVANNAH, GA 31410-3164
(912) 897-3086
Mailing address
112 WIGMORE CT, SAVANNAH, GA 31410-3164
(912) 897-3086

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
000787
GA

Other

Enumeration date
01/29/2008
Last updated
01/29/2008
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