Individual
MRS. JESSICA AMBER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
201 EPPES ST, HOPEWELL, VA 23860-2717
(804) 541-1445
Mailing address
14403 COURTHOUSE RD, DINWIDDIE, VA 23841-2738
(620) 255-1226
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001204
VA
Other
Enumeration date
08/25/2013
Last updated
08/25/2013
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