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1184138919
DETRA WILSON
COLUMBUS, OH
NPI
1184138919
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Other Name
DETRA WILSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-12-01
Last Update Date
2017-12-01
Business Address
DETRA WILSON M.Ed
16 W LONG ST
COLUMBUS, OH 43215-2815
Phone number: 614-323-1285
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Mailing Address
DETRA WILSON M.Ed
1046 LAVENDER LN
COLUMBUS, OH 43207-4290
Phone number:
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