Individual
AMY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
87 SWIERKOS DR, MOUNDSVILLE, WV 26041-4209
(304) 843-0910
Mailing address
1208 WARWOOD AVE APT 114, WHEELING, WV 26003-7151
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255523494
—
WV
05
—
1821206228
—
WV
Enumeration date
09/17/2020
Last updated
09/17/2020
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