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1811449895
BEVERLY WILSON
SHREVEPORT, LA
NPI
1811449895
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-10-26
Last Update Date
2016-10-26
Business Address
-- BEVERLY WILSON
9403 MANSFIELD RD
SHREVEPORT, LA 71118-3815
Phone number: 903-701-0425
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Mailing Address
-- BEVERLY WILSON
PO BOX 5
RODESSA, LA 71069-0005
Phone number:
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