Individual
MS. KAILA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 301-8854
Mailing address
2515 FEDERAL AVENUE, LOS ANGELES, CA 90064
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
GC001651
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GC001651
GENETIC COUNSELLING LICENSE
CA
Enumeration date
09/22/2022
Last updated
09/22/2022
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