Individual
SHAREEN WILSON
Active
Individual
SHAREEN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC,LMT
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25 005230
NY
172M00000X
Mechanotherapist
27 019967
NY
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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