Individual
MRS. DIANA LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
550 OSBORN BLVD STE 1006, SAULT SAINTE MARIE, MI 49783-1899
(906) 635-2969
(906) 635-3114
Mailing address
550 OSBORN BLVD STE 1006, SAULT SAINTE MARIE, MI 49783-1899
(906) 635-2969
(906) 635-3114
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704195098
MI
Other
Enumeration date
01/19/2012
Last updated
05/12/2013
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