Individual
VAUNASHA LAUTRICE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(800) 517-6935
Mailing address
4755 DARIUS DR, JACKSON, MS 39209-4902
(601) 540-5524
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1300
MS
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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