Most Relevant Information
Provider Data
| NPI Number: | 1003592783 |
| Provider Name: | SHAYLA RAECHELLE WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/26/2023 |
| Last Updated: | 06/26/2023 |
Provider Practice Location
5501 DELMAR BLVD STE B300
SAINT LOUIS
MO
631123078
Practice Location Phone/Fax
| Phone: | 3146286205 |
| Fax: |
Provider Mailing Location
5501 DELMAR BLVD STE B300
SAINT LOUIS
MO
631123078
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |