Individual
LILLIAN POWELL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.O.T., O.T.R.
Contact information
Practice address
5601 BRIDGE ST, FORT WORTH, FORT WORTH, TX 76112-2384
(817) 457-9850
(817) 457-9865
Mailing address
1405 S ADAMS ST, FORT WORTH, FORT WORTH, TX 76104-4406
(817) 927-9525
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109848
TX
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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