Individual
CHRISTIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5456 SALEM SPRINGS DR, LITHONIA, GA 30038-4821
(817) 567-6098
Mailing address
5456 SALEM SPRINGS DR., LITHONIA, GA 30038
(817) 567-6098
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
Primary
—
—
172A00000X
Driver
—
—
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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