Search › Maryland › 104100000X
Reva Wilson
NPI 1659817021 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1516 Northern Lights Dr
Upper Marlboro, MD 20774 - Phone
- (407) 408-4518
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-01-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland