Organization
DREAMWORKS CHILDRENS THERAPY NETWORK
Active
Other names
WILSON THERAPEUTIC INC
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI WILSON (OWNER)
(678) 918-3380
Entity
Organization
Contact information
Practice address
620 POWDER SPRINGS ST SE, SUITE E, SMYRNA, GA 30080
(678) 918-3380
Mailing address
620 POWDER SPRINGS ST SE, SUITE E, SMYRNA, GA 30080
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
909280912A
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
909280912A
—
GA
Enumeration date
11/17/2006
Last updated
06/13/2008
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