Individual
LINDEE AVIANNAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 COOPER RD, LUCEDALE, MS 39452-4708
(601) 530-6634
Mailing address
117 COOPER RD, LUCEDALE, MS 39452-4708
(601) 530-6634
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/10/2025
Last updated
06/10/2025
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