Individual
MISS SANDRA D WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
5461 PORTMAN DR, NOBLESVILLE, IN 46062-8225
(317) 413-9608
Mailing address
5461 PORTMAN DR, NOBLESVILLE, IN 46062-8225
(317) 419-7794
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
230162951
IN
Other
Enumeration date
08/17/2020
Last updated
08/07/2023
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