Individual
DEJA DENISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1744 PAYNE AVE, CLEVELAND, OH 44114-2910
(216) 623-6555
Mailing address
1744 PAYNE AVE, CLEVELAND, OH 44114-2910
(216) 623-6555
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2202813-TRNE
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/08/2020
Last updated
07/06/2023
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