Most Relevant Information
Provider Data
| NPI Number: | 1003398306 |
| Provider Name: | EMILY WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/04/2018 |
| Last Updated: | 09/04/2018 |
Provider Practice Location
19101 N US HIGHWAY 119
CUMBERLAND
KY
408238107
Practice Location Phone/Fax
| Phone: | 6065894734 |
| Fax: |
Provider Mailing Location
1008 COLDIRON HTS
BAXTER
KY
408068418
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |