Crystal Rae Wilson
Crystal Rae Wilson is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Shade, Ohio. Practices as a sole proprietor. Licensed in Ohio.
- Licensed in
- OH
- In the registry since
- 2022
Practice location Address checks out
40328 Burlingham RdShade, OH 45776-9505
Phone: (740) 590-9205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X (OH) |
|---|
Record details
| NPI number | 1477279446 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | October 12, 2022 |
| Last updated in NPPES | October 12, 2022 |
| Certification date | October 12, 2022 |