Individual
KACI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
37283 SWAMP RD STE 501, PRAIRIEVILLE, LA 70769-3329
(225) 744-1717
Mailing address
14460 LAKE CROSSING DR, GONZALES, LA 70737-9426
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
301780
LA
225XP0200X
Pediatric Occupational Therapist
Primary
301780
LA
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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