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Organization
WILSON PEDIATRIC THERAPY LLC
Active
Organization
WILSON PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRESTA L WILSON (OWNER/CEO)
(859) 475-4305
Entity
Organization
Contact information
Practice address
424 LEWIS HARGETT CIR STE B100, LEXINGTON, KY 40503-3683
(859) 475-4305
Mailing address
424 LEWIS HARGETT CIR STE B100, LEXINGTON, KY 40503-3683
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/08/2021
Last updated
07/26/2021
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