Provider Demographics
NPI:1871640656
Name:WILSON, APRIL (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 BREVARD RD STE 10
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-8563
Mailing Address - Country:US
Mailing Address - Phone:828-670-8056
Mailing Address - Fax:828-670-8057
Practice Address - Street 1:1025 BREVARD RD STE 10
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-8563
Practice Address - Country:US
Practice Address - Phone:828-670-8056
Practice Address - Fax:828-670-8057
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4141225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301347Medicaid
NC136IFOtherBCBSNC