Individual
BAILEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 661-6275
Mailing address
4 OAKBROOK CT APT 3, BLOOMINGTON, IL 61704-2270
(815) 883-1797
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013521
IL
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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