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General NPI Number Information
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NPI Number | 1962102384
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Entity Type | Individual
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Provider Name | EMILY ANN WILSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 9821 E BELL RD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2344
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Country | US
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Telephone | 602-697-3457
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Fax |
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Provider Business Mailing Address
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Address Line | 24 E KEIM DR
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City | PHOENIX
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State | AZ
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Zip | 85012-1261
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Country | US
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Telephone | 602-541-9702
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTH-008204
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License Number State | AZ
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