Individual
MS. STACY J WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
3355 E SEMORAN BLVD, APOPKA, FL 32703-6062
(407) 862-6263
(407) 862-4188
Mailing address
3355 E SEMORAN BLVD, APOPKA, FL 32703-6062
(407) 862-6263
(407) 862-4188
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
8497
FL
Other
Enumeration date
09/22/2017
Last updated
07/21/2022
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