Individual
CARRIE ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5077 CREEK RD, MEDINA, NY 14103-9525
(585) 798-1476
Mailing address
5077 CREEK RD, MEDINA, NY 14103-9525
(585) 798-1476
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
011512-1
NY
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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