Individual
ROSE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RAC
Contact information
Practice address
212 MEDICAL DR, NATCHITOCHES, LA 71457-6052
(318) 357-3283
(318) 357-3287
Mailing address
212 MEDICAL DR, NATCHITOCHES, LA 71457-6052
(318) 357-3283
(318) 357-3287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1136
LA
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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