Individual
CONNIE T WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13302 BENWOOD AVE, CLEVELAND, OH 44105-4606
(216) 256-6101
Mailing address
13302 BENWOOD AVE, CLEVELAND, OH 44105-4606
(216) 256-6101
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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