Individual
ELIZABETH R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
624 MARKET AVE. N., CANTON, OH 44702-1017
(330) 493-4553
(330) 493-3761
Mailing address
624 MARKET AVE. N, CANTON, OH 44702-1017
(330) 493-4553
(330) 493-3761
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PN095547
OH
164W00000X
Licensed Practical Nurse
Primary
PN095547
OH
Other
Enumeration date
10/22/2007
Last updated
04/14/2016
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