Individual
SHALIAH DEAISJA MONTEIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 GEORGE BISHOP PKWY, MYRTLE BEACH, SC 29579-7335
(866) 850-6585
Mailing address
7218 BROOMSTRAW CT, NICHOLS, SC 29581-6208
(866) 850-6585
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
SC
Other
Enumeration date
01/26/2026
Last updated
01/26/2026
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