Individual
NICOLE WILKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
222 LADEAN CT STE E, SIMPSONVILLE, SC 29680-7504
(645) 587-5198
Mailing address
222 LADEAN CT STE E, SIMPSONVILLE, SC 29680-7504
(864) 558-7519
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-89795
NC
225X00000X
Occupational Therapist
Primary
.6669
SC
Other
Enumeration date
06/24/2019
Last updated
10/06/2022
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