Individual
DEBORAH WILSON
Active
Individual
DEBORAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
27628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003993
—
WV
Enumeration date
11/08/2006
Last updated
11/17/2016
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