Wendy Grace Matlack, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT007635 Issued in OH

Practice address

6805 Sylvania Ave
Sylvania, OH 43560-3683

Phone

(419) 882-0029

NPI assigned

Oct 8, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1871255737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 OWEN RD",
            "city": "NORTHWOOD",
            "state": "OH",
            "postal_code": "436192222",
            "telephone_number": "419-367-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 SYLVANIA AVE",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435603683",
            "telephone_number": "419-882-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLACK",
        "first_name": "WENDY",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT007635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Occupational Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.