Individual
MELISSA A WILDERMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
401 PENWOOD DR, EDGEWATER, MD 21037-3441
(443) 875-2023
Mailing address
401 PENWOOD DR, EDGEWATER, MD 21037-3441
(443) 875-2023
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
06497
MD
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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