Individual
KATHLEEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
464 ROUTE 17A, FLORIDA, NY 10921-1014
(845) 651-2251
Mailing address
72 PRICES SWITCH RD, WARWICK, NY 10990-2324
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
002885-1
NY
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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