Individual
SHAKIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6104 OLD BRANCH AVE, TEMPLE HILLS, MD 20748-2557
(301) 702-6175
Mailing address
6104 OLD BRANCH AVE, TEMPLE HILLS, MD 20748-2557
(301) 702-6175
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
10049912
MD
183700000X
Pharmacy Technician
T13475
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10049912
PTCB/CPHT
MD
Enumeration date
05/14/2018
Last updated
05/14/2018
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