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Individual

KRYSTAL WILSON I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1745 OATES DR, APT 717, MESQUITE, TX 75150-8801
(214) 916-9524
Mailing address
1745 OATES DR, APT 717, MESQUITE, TX 75150-8801
(214) 916-9524

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
09/02/2015
Last updated
09/02/2015
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