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Individual

ELIZABETH WILMOTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
7549 NORTH AVENUE, PHEONIX, AZ 85021
(888) 873-4221
Mailing address
524 BROOKWOOD LN, RAYMORE, MO 64083-9404

Taxonomy

Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
2008001152
MO

Other

Enumeration date
01/09/2015
Last updated
01/09/2015
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