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Individual

MRS. BRENDA JOYCE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
STNA

Contact information

Practice address
791 E 156TH ST, CLEVELAND, OH 44110-3069
(216) 851-0415
(216) 851-0415
Mailing address
791 E 156TH ST, CLEVELAND, OH 44110-3069
(216) 851-0415
(216) 851-0415

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
401618880314
OH

Other

Enumeration date
05/29/2014
Last updated
05/29/2014
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