Individual
JOLENE WILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
80 STONY GAP RD, COGAN STATION, PA 17728-8602
(570) 651-5544
Mailing address
80 STONY GAP RD, COGAN STATION, PA 17728-8602
(570) 651-5544
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP005950
PA
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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