Provider Demographics
NPI:1750711263
Name:WILEN, SHOSHANA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:
Last Name:WILEN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 W 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1172
Mailing Address - Country:US
Mailing Address - Phone:314-308-2190
Mailing Address - Fax:
Practice Address - Street 1:4801 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1172
Practice Address - Country:US
Practice Address - Phone:314-308-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist