Individual
MS. STEPHANIE MABEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 WEST OCEAN BLVD, SUITE 100, LONG BEACH, CA 90802
(562) 491-5807
(562) 983-5747
Mailing address
9150 EAST IMPREIAL HIGHWAY, ROOM P-31, DOWNEY, CA 90242
(562) 940-3694
(562) 658-4725
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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