Individual
MRS. KATRINA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1416 GRIFFIN RD APT 57, LEESBURG, FL 34748-3439
(352) 396-5254
Mailing address
PO BOX 490623, LEESBURG, FL 34749-0623
(352) 396-5254
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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