Individual
JENNIFER JOAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 POCAHONTAS TRL, WHITE SULPHUR SPRINGS, WV 24986-9793
(304) 536-4661
Mailing address
425 BROKEN STAR ACRES RD, LEWISBURG, WV 24901-9664
(304) 894-5060
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C2098
WV
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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