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NPI Code Detail

MEDICARE: AMELIA WILSON MS

MEDICARE: AMELIA WILSON MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist901015618MA

General Provider Information

NPI Number : 1306514179
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA WILSON MS
Provider Business Mailing Address
First Line : PO BOX 681
Second Line :
City : LANESBOROUGH
State : MA
Zip : 01237-0681
Country : US
Telephone Number : 413-345-1788
Fax Number :
Provider Business Practice Location Address
First Line : 24 PARK ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-0900
Country : US
Telephone Number : 413-499-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2021
Last Update Date : 09/05/2021

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