Individual
ELASIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1009 CHESTER ST, ALEXANDRIA, LA 71301
(318) 664-4992
Mailing address
1009 CHESTER STREET, ALEXANDRIA, LA 71301
(318) 664-4992
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/28/2015
Last updated
05/31/2018
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