Individual
DOMINQUE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25639 FORD RD, DEARBORN HEIGHTS, MI 48127-4817
(313) 277-3293
(313) 277-0917
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
(602) 248-8999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704360018
MI
Other
Enumeration date
09/24/2025
Last updated
09/25/2025
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