Individual
GRETCHEN ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOTRL
Contact information
Practice address
2400 UNSER BLVD SE, RIO RANCHO, NM 87124-3392
(505) 401-4235
Mailing address
7019 CLARK HILLS DR NE, RIO RANCHO, NM 87144-8677
(505) 401-4235
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2100
NM
Other
Enumeration date
01/22/2007
Last updated
12/30/2011
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