Individual
NATASHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
959 MEMORIAL BLVD, PICAYUNE, MS 39466-4635
(601) 347-6112
Mailing address
1008 TIMBERWOOD LN, PICAYUNE, MS 39466-2345
(601) 347-6112
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
515545
MS
1744P3200X
Prosthetics Case Management
—
—
246RP1900X
Phlebotomy Technician
Primary
H3T8J8P4
MS
Other
Enumeration date
04/05/2019
Last updated
09/01/2020
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