Individual
BRADLEY LEMOND WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, COTA/L
Contact information
Practice address
10293 N MERIDIAN ST STE 125, CARMEL, IN 46290-1123
(317) 316-7128
Mailing address
28415 N DUCK CREEK AVE, ATLANTA, IN 46031-9747
(317) 316-7128
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225700000X
Massage Therapist
Primary
MT2207871
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1070991
NATIONAL BOARD OF CERTIFICATION IN OCCUPATIONAL THERAPY, INC.
—
01
—
32001316A
INDIANA PROFESSIONAL LICENSING AGENCY: OCCUPATIONAL THERAPY COMMITTEE
IN
01
—
MT2207871
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
03/22/2010
Last updated
04/05/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us