Individual
WANDA LISA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 DOGWOOD DR, PHILIPSBURG, PA 16866-1982
(814) 342-8400
Mailing address
1043 TROY HAWK RUN HWY, PHILIPSBURG, PA 16866-7922
(814) 553-1659
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP007296
PA
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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