Individual
SHAMBRICA L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2875 STONEWOOD CIR, LAKELAND, FL 33810-4005
(863) 808-3043
Mailing address
2875 STONEWOOD CIR, LAKELAND, FL 33810-4005
(863) 808-3043
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
399900
CNA
FL
Enumeration date
08/23/2021
Last updated
08/23/2021
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