Individual
MRS. KATHYANN P WILSON-BEAUFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5710 RITCHIE HWY, BROOKLYN PARK, MD 21225-3641
(410) 636-5600
(410) 636-5600
Mailing address
1202 PLAZA CIR, JOPPA, MD 21085-3608
(347) 593-1281
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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