Individual
MRS. TWILA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5741 D IMBODEN STREET, COLUMBIA, SC 29206
(734) 288-6644
(803) 708-0112
Mailing address
5741 IMBODEN ST APT D, COLUMBIA, SC 29206-5717
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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