| NPI | 1740821685 |
|---|---|
| Former Name | KATLYN BROOKE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NC 12294) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NC 12294) |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2021-04-14 |