Individual
MRS. JOVENE IDANA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR-L
Contact information
Practice address
41 HENDRICKSON PASS, HARLAN, KY 40831-7117
(606) 574-9245
Mailing address
41 HENDRICKSON PASS, HARLAN, KY 40831-7117
(606) 574-9245
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
KY-R1893
KY
Other
Enumeration date
07/19/2015
Last updated
07/19/2015
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