Individual
DEKENIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18307 FARMINGTON RD, LIVONIA, MI 48152-3253
(313) 221-4197
Mailing address
18307 FARMINGTON RD, LIVONIA, MI 48152-3253
(313) 221-4197
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
02/26/2022
Last updated
12/15/2022
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