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Individual

MS. DIANE H. WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9212 FAIRLANE PL, LAUREL, MD 20708-2860
(240) 568-9313
(410) 605-7731
Mailing address
9212 FAIRLANE PL, LAUREL, MD 20708-2860
(240) 568-9313
(410) 605-7731

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/15/2006
Last updated
07/08/2007
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