Individual
ALINA ERENNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 N 200 E, IVINS, UT 84738-6100
(435) 634-5220
Mailing address
206 N 2100 W, SALT LAKE CITY, UT 84116-4740
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
10215238-4202
UT
Other
Enumeration date
03/05/2018
Last updated
03/05/2018
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