Individual
ALICIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4590 VALLEY PKWY SE APT G, SMYRNA, GA 30082-4981
(470) 503-8053
Mailing address
4590 VALLEY PKWY SE APT G, SMYRNA, GA 30082-4981
(470) 503-8053
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN254415
GA
Other
Enumeration date
01/02/2022
Last updated
01/02/2022
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