Provider Demographics
NPI:1871899187
Name:WRIGHT JOHNSTON, WENDY K (COTA/L)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:K
Last Name:WRIGHT JOHNSTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01905-1202
Mailing Address - Country:US
Mailing Address - Phone:781-599-7756
Mailing Address - Fax:
Practice Address - Street 1:341 LINWOOD ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-1202
Practice Address - Country:US
Practice Address - Phone:781-599-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2089224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant