Individual
MRS. ADAMA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
503 GRASSLANDS RD, SUITE 101, VALHALLA, NY 10595-1503
(914) 593-0593
Mailing address
503 GRASSLANDS ROAD, SUITE 101, VALHALLA, NY 10595
(914) 593-0593
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2958361
NY
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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