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1043820566
LATISHIA M WILSON
BAY PINES, FL
NPI
1043820566
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW14703)
Enumeration Date
2020-08-10
Last Update Date
2020-08-10
Business Address
Mrs. LATISHIA M WILSON LCSW
10000 BAY PINES BLVD
BAY PINES, FL 33744-8200
Phone number: 727-398-6661
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Mailing Address
Mrs. LATISHIA M WILSON LCSW
113 38TH AVE SE
ST PETERSBURG, FL 33705-4063
Phone number: 314-494-0685
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