Individual
MRS. KAITLYN MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1475 HOLCOMB BRIDGE RD STE 113, ROSWELL, GA 30076-2126
(678) 591-3542
Mailing address
7490 MCBRAYER RD, CUMMING, GA 30028-7999
(770) 365-0302
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
20408
FL
Other
Enumeration date
10/14/2019
Last updated
09/10/2021
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