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MRS. KIMBERLY RENAE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
208 COUNTRY CLUB DR, BENTON, LA 71006-9463
(318) 507-9909
Mailing address
208 COUNTRY CLUB DR, BENTON, LA 71006-9463
(318) 507-9909

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3055
CO

Other

Enumeration date
05/27/2011
Last updated
08/07/2018
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