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Organization

TRACY WILSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TRACY WILSON MS, OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(301) 869-7505
Entity
Organization

Contact information

Practice address
17620 REDLAND RD STE A, ROCKVILLE, MD 20855-1245
(301) 869-7505
(301) 869-7515
Mailing address
17620 REDLAND RD STE A, ROCKVILLE, MD 20855-1245
(301) 869-7505
(301) 869-7515

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
03971
MD

Other

Enumeration date
04/29/2013
Last updated
04/29/2013
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