Individual
TAMIKA FLORA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1099 E 169TH ST, CLEVELAND, OH 44110-1520
(216) 785-0166
Mailing address
1099 E 169TH ST, CLEVELAND, OH 44110-1520
(216) 785-0166
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OH006343
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0237251
—
OH
Enumeration date
06/23/2011
Last updated
02/14/2018
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