Individual
REBECCA J WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DROT, LOTR
Contact information
Practice address
1450 CLAIBORNE AVE, SHREVEPORT, LA 71103
(318) 813-2970
(318) 813-2981
Mailing address
1450 CLAIBORNE AVE, SHREVEPORT, LA 71103-4204
(318) 813-2970
(318) 813-2981
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT16401
CA
Other
Enumeration date
08/24/2017
Last updated
12/16/2022
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