Individual
ASHARA LANISE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 RAINIER AVE S STE 201, SEATTLE, WA 98144-4642
(901) 494-4385
Mailing address
6097 ELK GROVE RD, MEMPHIS, TN 38115-6244
(901) 494-4385
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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