Individual
KELSIE WASILUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
60 HARBOR TOWN SQ APT 205, MEMPHIS, TN 38103-5747
(479) 409-1442
Mailing address
60 HARBOR TOWN SQ APT 205, MEMPHIS, TN 38103-5747
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6628
TN
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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