Individual
ELEASIA JOANETTA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4348 S JEFFREY DR, BATON ROUGE, LA 70816-4196
(225) 361-0483
Mailing address
4348 S JEFFREY DR, BATON ROUGE, LA 70816-4196
(225) 361-0483
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC-5132
LA
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/29/2017
Last updated
04/04/2023
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