Individual
MRS. ALISHA DAWN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2101 HOMESTEAD HILLS DRIVE, WINSTON SALEM, NC 27103
(336) 774-8942
Mailing address
2312 DAWSON STREET, KANNAPOLIS, NC 28081
(980) 829-7786
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11033
NC
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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