Individual
MELISSA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4711 RIGHTWAY AVE, SHREVEPORT, LA 71108-2621
(318) 918-4107
Mailing address
4711 RIGHTWAY AVE, SHREVEPORT, LA 71108-2621
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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