Individual
QUIANA JAVA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 AARANS POND DR, #101, TAMPA, FL 33612
(813) 360-3489
Mailing address
2311 ALTERNATE 19N, PALM HARBOUR, FL 34683
(813) 360-3489
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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