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Individual

ALEXANDER A WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, OTR/L

Contact information

Practice address
91 MORAINE ST, JAMAICA PLAIN, MA 02130-4329
(303) 669-8863
Mailing address
91 MORAINE ST, JAMAICA PLAIN, MA 02130-4329

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9861
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
251638
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
Enumeration date
07/23/2009
Last updated
07/23/2009
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