Healthcare Provider Details

I. General information

NPI: 1528904281
Provider Name (Legal Business Name): CATHERINE L WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 N 144TH ST STE 3
OMAHA NE
68154-4715
US

IV. Provider business mailing address

3023 S 121ST ST
OMAHA NE
68144-3982
US

V. Phone/Fax

Practice location:
  • Phone: 402-515-6219
  • Fax:
Mailing address:
  • Phone: 402-515-6219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: