Individual
TANIEKA TA'SHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9367 TWO NOTCH RD STE 106, COLUMBIA, SC 29223-6442
(205) 526-6060
Mailing address
1014 TURTLE STONE RD, BLYTHEWOOD, SC 29016-9267
(205) 526-6060
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
13127
SC
225700000X
Massage Therapist
5461
AL
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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