Most Relevant Information
Provider Data
| NPI Number: | 1003348319 |
| Provider Name: | TEONNA WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/28/2017 |
| Last Updated: | 03/28/2017 |
Provider Practice Location
1351 NEWTOWN PIKE
LEXINGTON
KY
405111275
Practice Location Phone/Fax
| Phone: | 8592531686 |
| Fax: |
Provider Mailing Location
3611 KEYSTONE CT
LEXINGTON
KY
405173424
Provider Mailing Phone/Fax
| Phone: | 2709941164 |
| Fax: |