Individual
MARIA LORENA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1125 CAMBRIDGE AVE E, GREENWOOD, SC 29646-2946
(864) 941-5563
Mailing address
1125 CAMBRIDGE AVE E, GREENWOOD, SC 29646-2946
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2352
SC
Other
Enumeration date
05/31/2013
Last updated
05/31/2013
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