Individual
KAYLA SUTHERLAND WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-4411
Mailing address
101 CRESCENT CT, WOODSTOCK, GA 30189-6601
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007246
GA
Other
Enumeration date
10/07/2019
Last updated
11/29/2022
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