Individual
DESHARA L WILSON
Active
Individual
DESHARA L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA93749
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0557
0557
FL
01
—
0557
DESHARA WILSON
—
Enumeration date
09/24/2020
Last updated
09/24/2020
Update your record
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