Individual
MRS. ARTENTUS LASHA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
426 LEON SULLIVAN WAY STE 134, CHARLESTON, WV 25301-1713
(704) 361-1999
Mailing address
215 N PINE ST UNIT 403, CHARLOTTE, NC 28202-2086
(704) 361-1999
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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