Individual
DEMETRA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3761 STOCKER ST STE 105, LOS ANGELES, CA 90008-5129
(323) 294-4261
(323) 294-7261
Mailing address
3840 POTOMAC AVE APT 25, LOS ANGELES, CA 90008-1631
(323) 815-1846
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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