EBONY WILSON
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Active
Individual
NPI: 1013334622
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 320900000X | Yes | - |
Frequently Asked Questions
NPI 1013334622 is the National Provider Identifier for EBONY WILSON, a Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities provider located in Saint Louis, MO. This NPI was enumerated on March 20, 2014.
EBONY WILSON practices at 3514 BLAIR AVE, Saint Louis, MO 63107.
Quick Facts
- NPI
- 1013334622
- Type
- Individual
- Enumerated
- Mar 20, 2014
- Last Updated
- Mar 20, 2014
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