Provider Demographics
NPI:1902283583
Name:WILCOCK, JOY DENISE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DENISE
Last Name:WILCOCK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:JOY
Other - Middle Name:DENISE
Other - Last Name:YULICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2556 X4 RD
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534-9479
Mailing Address - Country:US
Mailing Address - Phone:785-284-0460
Mailing Address - Fax:
Practice Address - Street 1:2556 X4 RD
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534-9479
Practice Address - Country:US
Practice Address - Phone:785-284-0460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-02
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE442225X00000X
KS17-01035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist