Individual
NANNETTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
729 S LACLEDE STATION RD, SAINT LOUIS, MO 63119-4911
(314) 446-2456
Mailing address
729 S LACLEDE STATION RD, SAINT LOUIS, MO 63119-4911
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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