Most Relevant Information
Provider Data
| NPI Number: | 1003421819 |
| Provider Name: | LORETTA WILSON CDCA, PEER SUPPORT |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/09/2020 |
| Last Updated: | 05/11/2022 |
Provider Practice Location
525 METRO PL N STE 100
DUBLIN
OH
430175343
Practice Location Phone/Fax
| Phone: | 6143390806 |
| Fax: |
Provider Mailing Location
525 METRO PL N STE 100
DUBLIN
OH
430175343
Provider Mailing Phone/Fax
| Phone: | 6143390806 |
| Fax: |