Individual
JENNIFER LEIGH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCA
Contact information
Practice address
611 PEARL BATES AVE APT 30, EASTMAN, GA 31023-5576
(478) 230-5477
Mailing address
611 PEARL BATES AVE APT 30, EASTMAN, GA 31023-5576
(478) 230-5477
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/25/2024
Last updated
04/01/2024
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