Wilson, Latisha

Wilson, Latisha is an individual health care provider with primary practice located at 10 Meadowbrook Rd , Brockton MA 02301-7122. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Wilson, Latisha can be contacted via phone (774) 213-8837.

Contact Information

Primary practice address
10 Meadowbrook Rd Brockton MA 02301-7122
Phone: (774) 213-8837
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1265986863
LBN Legal business name Wilson, Latisha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2016
Last updated Aug 11th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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