Individual
MRS. ANDREA C WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 ACADEMY CT, PAINESVILLE, OH 44077-2705
(440) 339-7868
Mailing address
8532 MENTOR AVE, MENTOR, OH 44060-5822
(440) 205-1008
(440) 205-1047
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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