Individual
MS. 'KELLY' WILK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2102 PROMONTORY PT, PLANO, TX 75075-3547
(239) 777-4009
(972) 612-6804
Mailing address
2102 PROMONTORY PT, PLANO, TX 75075-3547
(239) 777-4009
(972) 612-6804
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113753
TX
225X00000X
Occupational Therapist
7324
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2823296
—
TX
05
—
886525600
—
FL
05
—
888439100
—
FL
Enumeration date
11/25/2006
Last updated
09/16/2013
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