Wanda Faye Wilson

NPI 1043643133 - Custodial Care Facility - 311ZA0620X

NPI Details
NPI 1043643133
Gender Female
Enumeration Date 08/13/2013
Last Updated 08/13/2013
Entity Type Individual
Active Over 5 years ago
Practice Location
2510 ST AUGUSTINE RD
MONTICELLO FL, 32344-6938, US
Phone (850) 780-0426
Fax
Business Location
2510 ST AUGUSTINE RD
MONTICELLO FL, 32344-6938, US
Phone (850) 780-0426
Fax
Toxanomy
Taxonomy Code 311ZA0620X
License State Florida
License Number 6906542
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According to our database, Ms. Wanda Faye Wilson NPI is 1043643133, taxonomy code is 311ZA0620X and license number is 6906542, license state is located at Florida. Wanda Faye Wilson physically located at 2510 St Augustine Rd, Monticello FL, 32344-6938. NPI Number Wanda Faye Wilson has the Individual type.

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1043643133 NPI number is provided on an as is basis without warranty of any kind. 1043643133 is maintained by the National Plan & Provider Enumeration System. The contents of Wanda Faye Wilson are for informational purposes only.