Individual
LAQUEITIA S WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
785 ROBERSON STREET, FALL RIVER, MA 02721
(774) 379-2617
Mailing address
143 FOUNTAIN ST, FALL RIVER, MA 02721-1309
(774) 379-2617
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN88463
MA
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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