Individual
CONNIE COLLEEN WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4815 SHARPE RD, ANACORTES, WA 98221-8403
(360) 770-1752
Mailing address
4815 SHARPE RD, ANACORTES, WA 98221-8403
(360) 770-1752
Taxonomy
Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
Primary
60850227
WA
225XG0600X
Gerontology Occupational Therapist
60850227
WA
225XP0019X
Physical Rehabilitation Occupational Therapist
60850227
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60850227
OCCUPATIONAL THERAPIST LICENSE
WA
Enumeration date
01/07/2020
Last updated
01/07/2020
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