Individual
DAREIN LEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
175 COLONIAL DRIVE, MANSFIELD, OH 44903
(419) 564-2524
Mailing address
175 COLONIAL DRIVE, MANSFIELD, OH 44903
(419) 564-2524
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401164251110
OH
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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