Individual
RENEE MICHELE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1406 NW JUNIPER ST, BEND, OR 97703-1547
(541) 537-0829
Mailing address
62610 MCCLAIN DR, BEND, OR 97703-8616
(541) 537-0829
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1023704
OR
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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