Individual
ANITA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
149 HALYBURTON MEMORIAL PKWY APT 103, WILMINGTON, NC 28412-2660
(919) 223-0003
Mailing address
149 HALYBURTON MEMORIAL PKWY APT 103, WILMINGTON, NC 28412-2660
(919) 223-0003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5763
NC
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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