Provider Demographics
NPI:1770654170
Name:WILKINSON, ALSIA BARBARA
Entity Type:Individual
Prefix:MRS
First Name:ALSIA
Middle Name:BARBARA
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALSIA
Other - Middle Name:BARBARA
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:1613 N HIATUS RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2129
Mailing Address - Country:US
Mailing Address - Phone:954-296-5971
Mailing Address - Fax:954-432-0050
Practice Address - Street 1:1613 N HIATUS RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-2129
Practice Address - Country:US
Practice Address - Phone:954-296-5971
Practice Address - Fax:954-432-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7325225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist