Provider Demographics
NPI:1306147707
Name:WILBER, MEG ELIZABETH (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:MEG
Middle Name:ELIZABETH
Last Name:WILBER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 MISTY WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9366
Mailing Address - Country:US
Mailing Address - Phone:919-435-6239
Mailing Address - Fax:
Practice Address - Street 1:611 BROOKS ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-2978
Practice Address - Country:US
Practice Address - Phone:919-554-4671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3172224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant