Most Relevant Information
Provider Data
| NPI Number: | 1003413345 |
| Provider Name: | NADA S WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | LGP12696 |
Most Important Dates
| Enumeration Date: | 10/08/2020 |
| Last Updated: | 06/03/2024 |
Provider Practice Location
VESTA
9301 ANNAPOLIS RD
LANHAM
MD
207061001
Practice Location Phone/Fax
| Phone: | 2402966300 |
| Fax: |
Provider Mailing Location
11000 HUNTERS VIEW RD
ELLICOTT CITY
MD
210426109
Provider Mailing Phone/Fax
| Phone: | 2402710079 |
| Fax: |