Individual
TERESA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
41 FARM ST, DANBURY, CT 06811-4612
(203) 297-5530
Mailing address
41 FARM ST, DANBURY, CT 06811-4612
(203) 297-5530
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
28736
CT
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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