Individual
KENDRAH DAWANNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1709 OSBORNE RD APT SUITE, SAINT MARYS, GA 31558-9141
(912) 540-0323
Mailing address
704 WHEELER ST APT SUITE, SAINT MARYS, GA 31558-8315
(912) 540-0323
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA105415
FL
225700000X
Massage Therapist
Primary
MT015102
GA
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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