Individual
PAMELA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7367 SPOUT SPRINGS RD, SUITE 125, FLOWERY BRANCH, GA 30542-5519
(770) 965-1861
(770) 965-1863
Mailing address
7367 SPOUT SPRINGS RD, SUITE 125, FLOWERY BRANCH, GA 30542-5519
(770) 965-1861
(770) 965-1863
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005586
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
303501
NBCOT
—
Enumeration date
12/12/2012
Last updated
12/12/2012
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