Provider Demographics
NPI:1821783556
Name:WILSON-HOWARD, DANESHA (CPT)
Entity Type:Individual
Prefix:
First Name:DANESHA
Middle Name:
Last Name:WILSON-HOWARD
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 WILLAMONT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2658
Mailing Address - Country:US
Mailing Address - Phone:614-648-7362
Mailing Address - Fax:
Practice Address - Street 1:2202 WILLAMONT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2658
Practice Address - Country:US
Practice Address - Phone:614-648-7362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy