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Individual

DEBRA LYNN WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DODD

Contact information

Practice address
14880 GAR HWY, CHARDON, OH 44024-9567
(440) 286-5895
Mailing address
14880 GAR HWY, CHARDON, OH 44024-9567
(440) 286-5895

Taxonomy

Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
OH
376J00000X
Homemaker
Primary
OH
385H00000X
Respite Care
2800688
OH

Other

Enumeration date
12/03/2020
Last updated
12/03/2020
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