Individual
MELISA ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
851 E SHERRI DR, GILBERT, AZ 85296-3643
(480) 570-4157
Mailing address
851 E SHERRI DR, GILBERT, AZ 85296-3643
(480) 570-4157
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2546
AZ
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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