Individual
MS. VANESSA DARLEEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
138 GRIFFIN ST NW, APT 8, ATLANTA, GA 30314-4073
(772) 985-9636
Mailing address
4747 S FULTON ST, APT 210, TULSA, OK 74135
(918) 270-4039
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/21/2006
Last updated
02/18/2009
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