Individual
MS. CAROLYN GRACE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
1200 EL CAMINO REAL, SOUTH SAN FRANCISCO, CA 94080-3208
(650) 742-2000
Mailing address
1171 FAIRMONT DR, SAN BRUNO, CA 94066-2719
(650) 952-4779
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3136
CA
Other
Enumeration date
01/09/2008
Last updated
01/03/2022
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