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Individual

LATONYA RAE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
737 MILBY DR, CHESAPEAKE, VA 23325-5009
(757) 738-0541
Mailing address
737 MILBY DR, CHESAPEAKE, VA 23325-5009
(757) 738-0541

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
095541
VA
251G00000X
Community Based Hospice Care Agency
095541
VA
315D00000X
Inpatient Hospice
095541
VA
374U00000X
Home Health Aide
095541
VA
385H00000X
Respite Care
095541
VA

Other

Enumeration date
11/08/2017
Last updated
11/13/2017
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