Individual
SHAWNYNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S, SUITE 301, SALT LAKE CITY, UT 84111-1700
(801) 322-4257
Mailing address
344 E 100 S, SUITE 301, SALT LAKE CITY, UT 84111-1700
(801) 322-4257
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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