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MISS DIEDRA MICHELLE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
38501 MENTOR AVE APT 250, WILLOUGHBY HILLS, OH 44094-7734
(216) 502-5313
Mailing address
38501 MENTOR AVE APT 250, WILLOUGHBY HILLS, OH 44094-7734
(216) 502-5313

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0038687
OH

Other

Enumeration date
11/05/2025
Last updated
11/05/2025
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