Individual
KATELYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
317 SCHOOL ST, O FALLON, MO 63366-2824
(636) 281-9815
Mailing address
3125 HIGHWAY P, WENTZVILLE, MO 63385-2312
(636) 357-3112
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2023009753
MO
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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