Individual
TASHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4451 SHEPHERDSVILLE RD, ELIZABETHTOWN, KY 42701-9519
(270) 750-9357
Mailing address
642 OLD STATE RD APT 1, BRANDENBURG, KY 40108-1144
(270) 750-9357
(270) 750-9357
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
KY
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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