Individual
SUSAN OSBORNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8919 PARK RD, CHARLOTTE, NC 28210-9600
(704) 556-3428
(704) 643-8026
Mailing address
120 ABBOTSBURY CT, WAXHAW, NC 28173-6529
(704) 844-9065
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2308
SC
225X00000X
Occupational Therapist
Primary
4012
NC
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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