Individual
COURTNEY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3104 WESTBURY LAKE DR APT D, CHARLOTTE, NC 28269-2219
(434) 299-8210
Mailing address
3104 WESTBURY LAKE DR APT D, CHARLOTTE, NC 28269-2219
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15644
NC
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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