NPI 1003962317
Michelle Anne Wildman, OTRL
Practice location
- Address
- 122 Eglin Pkwy NE, Fort Walton Beach, FL 32548-4917
- Phone
- (850) 543-6227
- Fax
- (850) 863-9974
- Mailing address
- 852 Radford CT, Shalimar, FL 32579-2169
Registered specialties
Developmentally Disabled Services Day Training Agency
Primary
Registry record
- NPI
- 1003962317
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 27 Jan 2007
- Record last updated
- 8 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.