Individual
JANESHIA R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
552 SPRINGRIDGE RD APT G3, CLINTON, MS 39056-5604
(601) 446-3044
Mailing address
665 S PEAR ORCHARD RD STE 106-697, RIDGELAND, MS 39157-4861
(601) 460-0121
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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