| NPI | 1114001237 |
|---|---|
| Former Name | SHERESA WILSON-DEVRIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601005190) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000892A) |
| 101YM0800X Counselor, Mental Health (Licence: IN 88001982A) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-04-26 |