Individual
JACINDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
517 EAST 120 ST.CLAIR, CLEVELAND, OH 44108-1845
(216) 240-0367
Mailing address
517 E 120TH ST, CLEVELAND, OH 44108-1845
(216) 240-0367
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
3153457
OH
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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