Individual
MRS. KRISTIN LYNNETTE MAUCK WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1390 KING TREE DR, DAYTON, OH 45405-1401
(937) 278-0723
Mailing address
5306 MANGROVE WAY, DAYTON, OH 45431-3533
(540) 793-1845
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004314
VA
225X00000X
Occupational Therapist
Primary
OT. 006762
OH
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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