Provider Demographics
NPI:1437464682
Name:ARCHIBALD, WENDY HUNT (PT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:HUNT
Last Name:ARCHIBALD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:MICHELLE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:244 BRIARCLIFF LN
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-6040
Mailing Address - Country:US
Mailing Address - Phone:434-841-5320
Mailing Address - Fax:
Practice Address - Street 1:300 W CLARENDON AVE
Practice Address - Street 2:SUITE 285
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-3420
Practice Address - Country:US
Practice Address - Phone:602-277-3686
Practice Address - Fax:602-277-3676
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3619225X00000X
FL013351225X00000X
AZ9457225100000X
AZ4749225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist