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1598305351
LORA NICOLE WILSON
KENNETT, MO
NPI
1598305351
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-01-09
Last Update Date
2020-01-09
Business Address
LORA NICOLE WILSON
1109 JONES ST
KENNETT, MO 63857-3824
Phone number: 573-888-5925
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Mailing Address
LORA NICOLE WILSON
1109 JONES ST
KENNETT, MO 63857-3824
Phone number: 573-888-5925
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