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Individual
MS. SUSAN ELAINE WILSON
Active
Individual
MS. SUSAN ELAINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
Primary
OT1289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0717141600
—
FL
05
—
880176200
—
FL
01
—
Z8875
BCBS
FL
Enumeration date
03/06/2007
Last updated
02/10/2022
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