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Individual

KATHRYN WILCOX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5970 CARVEL AVE, APT E, INDIANAPOLIS, IN 46220-2678
(317) 405-9016
(888) 654-4116
Mailing address
5970 CARVEL AVE, APT E, INDIANAPOLIS, IN 46220-2678
(317) 405-9016
(888) 654-4116

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005634A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31005634A
INDIANA OCCUPATIONAL LICENSE
IN
Enumeration date
07/10/2014
Last updated
07/10/2014
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