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Individual
BRIAN WILSON
Active
Individual
BRIAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079733108
DUNS
CO
Enumeration date
05/27/2015
Last updated
01/08/2024
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