Individual
SHARLANA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7854 SMYRNA ST, JACKSONVILLE, FL 32208-3160
(904) 437-9556
Mailing address
847 ASHTON COVE TER, JACKSONVILLE, FL 32218-3796
(904) 437-9556
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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