Provider Demographics
NPI:1801160130
Name:WILBERT, PAULA (OTR/L)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WILBERT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 BLACK BALL HILL RD
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-2240
Mailing Address - Country:US
Mailing Address - Phone:508-385-2799
Mailing Address - Fax:
Practice Address - Street 1:280D ROUTE 130
Practice Address - Street 2:SUITE 7
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1140
Practice Address - Country:US
Practice Address - Phone:508-833-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1562225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics