| NPI | 1003214982 |
|---|---|
| Former Name | NICOLE CLAIRE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: AR OT-a962) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AZ 5669) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2021-11-16 |