Individual
MARY EUVETTE WILSON-SHALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
607 RAILROAD DR, PORTLAND, TX 78374-1539
(361) 502-1793
Mailing address
PO BOX 1246, INGLESIDE, TX 78362-1246
(361) 563-3578
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014540
TX
Other
Enumeration date
12/13/2023
Last updated
07/12/2024
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