Individual
LATISHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 CARPENTER ST, DAINGERFIELD, TX 75638-2215
(903) 285-4332
Mailing address
1003 CARPENTER ST, DAINGERFIELD, TX 75638-2215
(903) 285-4332
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/29/2024
Last updated
06/29/2024
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