Individual
MRS. JENNIFER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
7304 CLANCY WAY, WESTERVILLE, OH 43082-9306
(614) 537-8475
Mailing address
7304 CLANCY WAY, WESTERVILLE, OH 43082-9306
(614) 537-8475
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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