Individual
LAKEISHA ALAINA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4609 KAMMER AVE, DAYTON, OH 45417-1135
(937) 793-9200
Mailing address
4609 KAMMER AVE, DAYTON, OH 45417-1135
(937) 793-9200
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
OH
372600000X
Adult Companion
—
OH
3747P1801X
Personal Care Attendant
—
OH
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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