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Individual

CHARNELLE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1130 47TH PL NE, WASHINGTON, DC 20019-3904
(202) 290-0619
Mailing address
832 52ND ST NE, WASHINGTON, DC 20019-5511
(202) 290-0619

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Enumeration date
01/16/2020
Last updated
01/16/2020
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