Individual
KATRINA WILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
10883 CREEKBRIDGE PL, SAN DIEGO, CA 92128-5108
(858) 603-5646
Mailing address
10883 CREEKBRIDGE PL, SAN DIEGO, CA 92128-5108
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
10297
CA
Other
Enumeration date
06/13/2013
Last updated
03/18/2023
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