STACEY A WILSON

BLOOMINGTON, IN
NPI1932890803
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: IN  31004123A)
Additional Taxonomies225XH1200X Occupational Therapist, Hand
(Licence: IN  31004123A)
Enumeration Date2023-05-19
Last Update Date2023-10-18
Business Address
STACEY A WILSON OT
2605 E CREEKS EDGE DR
BLOOMINGTON, IN 47401-8368
Phone number: 812-333-2663
Mailing Address
STACEY A WILSON OT
250 N SHADELAND AVE
INDIANAPOLIS, IN 46219-4959
Phone number: