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Individual

MRS. ILISSA CARYN WILK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
110 PLYMOUTH RD, PLAINVIEW, NY 11803-2723
(516) 433-3241
Mailing address
110 PLYMOUTH RD, PLAINVIEW, NY 11803-2723
(516) 433-3241

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008140-1
NY

Other

Enumeration date
01/12/2013
Last updated
01/12/2013
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