Licata Jeane Wilson
NPI #1093054249 in West Plains, Missouri
Provider Information
- NPI Number
- 1093054249
- Entity Type
- Individual
- Name
- Licata Jeane Wilson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Occupational Therapy Assistant
- Enumeration Date
- Feb 7, 2013
- Last Updated
- Feb 7, 2013
Practice Location
- Address
- 210 DAVIS DR
- City
- West Plains
- State
- Missouri
- ZIP Code
- 65775-2241
- Phone
- (417) 256-2152
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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