Individual
KAITLIN PATRICIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
3900 JERMANTOWN RD STE 250, FAIRFAX, VA 22030-4946
(703) 910-5006
Mailing address
11741 SUMMERCHASE CIR APT E, RESTON, VA 20194-1146
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008262
VA
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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