Individual
JILL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
193 SAM LISENBY RD, OZARK, AL 36360-3048
(334) 445-6336
(334) 445-6363
Mailing address
193 SAM LISENBY RD, OZARK, AL 36360-3048
(334) 445-6336
(334) 445-6363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2189
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51529853
BCBS
AL
Enumeration date
02/12/2007
Last updated
02/26/2008
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