Individual
MICAELA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
410 PEARL STREET, COLUMBIA, LA 71418
(318) 502-6845
Mailing address
PO BOX 1653, COLUMBIA, LA 71418-1653
(318) 502-6845
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
331892
LA
Other
Enumeration date
02/17/2023
Last updated
02/17/2023
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