Individual
KELLY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 NORTH WOLFE STREET, PATHOLOGY 401, BALTIMORE, MD 21287
(410) 955-3980
Mailing address
468 N LAKE SHORE DR, PALATINE, IL 60067-2369
(317) 531-4817
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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