Individual
GINA DEL WILCKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
854 E WILLIAMS FIELD RD STE 105, GILBERT, AZ 85295-0703
(480) 398-4280
Mailing address
PO BOX 50218, PHOENIX, AZ 85076-0218
(480) 398-4280
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-046756
AZ
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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