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Individual

DESHAWN E WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(707) 733-0188
Mailing address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(707) 733-0188

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13189
SC

Other

Enumeration date
09/10/2019
Last updated
09/10/2019
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