Individual
DIANE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 NEVINS ST, 7TH FLOOR, BROOKLYN, NY 11217-1004
(718) 855-4035
Mailing address
50 NEVINS ST, 7TH FLOOR, BROOKLYN, NY 11217
(718) 855-4035
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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