Individual
MELINDA WILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
501 GULLIVER ST, FOUNTAIN INN, SC 29644-2105
(864) 862-2554
Mailing address
27 HARMONY CIR, FOUNTAIN INN, SC 29644-1661
(864) 862-5506
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1937
SC
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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