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General NPI Number Information
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NPI Number | 1023253440
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Entity Type | Organization
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Legal Business Name | WILDWOOD OCCUPATIONAL THERAPY, INC.
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 245 WINKLERS CREEK RD UNIT B
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City | BOONE
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State | NC
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Zip | 28607-7838
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Country | US
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Telephone | 828-773-8477
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Fax | 877-384-7096
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Provider Business Mailing Address
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Address Line | PO BOX 2496
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City | BOONE
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State | NC
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Zip | 28607-2496
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Country | US
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Telephone | 828-773-8477
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Fax | 828-297-2138
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Authorized Official
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Title or Position | OT/L, DIRECTOR
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Name | NATALIE COOKE COOPER
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Credential | OT/L
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Telephone | 828-773-8477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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