Provider Demographics
NPI:1871127647
Name:BENDELE, TAYLOR MARIE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MARIE
Last Name:BENDELE
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:OTTOVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45876-0345
Mailing Address - Country:US
Mailing Address - Phone:419-890-9730
Mailing Address - Fax:
Practice Address - Street 1:800 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:OH
Practice Address - Zip Code:45828-1613
Practice Address - Country:US
Practice Address - Phone:419-678-5125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-02
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007105A225X00000X
OH225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist