Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ebony Wilson

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1013334622

Ebony Wilson is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Saint Louis, Missouri. Practices as a sole proprietor. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

3514 Blair Ave
Saint Louis, MO 63107-3717
Phone: (314) 216-0088
Show map & directions

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

Record details

NPI number1013334622
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 20, 2014
Last updated in NPPESMarch 20, 2014

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