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Organization

MICHELLE WILDMAN, OCCUPATIONAL THERAPIST, P.A.

Active
Other names
KIDZ KORNER
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE ANNE WILDMAN OT (DIRECTOR)
(850) 543-6227
Entity
Organization

Contact information

Practice address
122 EGLIN PKWY NE, FORT WALTON BEACH, FL 32548-4917
(850) 543-6227
(850) 863-9973
Mailing address
122 EGLIN PKWY NE, FORT WALTON BEACH, FL 32548-4917
(850) 543-6227
(850) 863-9973

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
11903
FL

Other

Enumeration date
11/18/2009
Last updated
11/18/2009
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