Individual
ANN ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1803 WOODFIELD DR, SAVOY, IL 61874-8815
(217) 355-5905
Mailing address
1370 E 1800 NORTH RD, MONTICELLO, IL 61856-8449
(217) 762-3229
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004385
IL
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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