Individual
DIONE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15868 WASHBURN ST, DETROIT, MI 48238-1066
(313) 826-5654
Mailing address
15868 WASHBURN ST, DETROIT, MI 48238-1066
(313) 826-5654
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113410
MI
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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