Individual
CHANTEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 N BROAD ST STE A, NEW ORLEANS, LA 70119-5507
(504) 577-1154
Mailing address
209 N BROAD ST STE A, NEW ORLEANS, LA 70119-5507
(504) 577-1154
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/18/2018
Last updated
05/18/2018
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