| NPI | 1134725203 |
|---|---|
| Former Name | NICOLE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 2103195) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2022-10-28 |