Individual
LACEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
9220 KIRBY DR STE 1000, HOUSTON, TX 77054-2534
(713) 383-9700
Mailing address
9220 KIRBY DR STE 1000, HOUSTON, TX 77054-2534
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
113551
TX
Other
Enumeration date
03/25/2016
Last updated
03/25/2016
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