Individual
KAYINI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 LINCOLN DR, SOUTH CHARLESTON, WV 25309-1834
(681) 205-8940
Mailing address
5635 MACCORKLE AVE SW APT 1A, SOUTH CHARLESTON, WV 25309-1059
(681) 317-5582
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
24-9142
WV
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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