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Individual

LASHANDA WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1565 EBENEZER RD STE 148, ROCK HILL, SC 29732-2494
(706) 513-0549
Mailing address
PO BOX 36715, ROCK HILL, SC 29732-0511

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
IHCP-1162
SC

Other

Enumeration date
12/31/2019
Last updated
01/12/2020
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