Individual
YAKITIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
608 MANNING ML, MACON, GA 31216-7378
(478) 461-2754
Mailing address
608 MANNING ML, MACON, GA 31216-7378
(478) 461-2754
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
04/02/2018
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