Individual
OLIVIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
444 EXECUTIVE CENTER BLVD, EL PASO, TX 79902-1058
(915) 600-2796
Mailing address
444 EXECUTIVE CENTER BLVD, EL PASO, TX 79902-1058
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214992
TX
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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