Provider Demographics
NPI:1952701302
Name:SANTIAGO-WILSON, AWILDA (ND)
Entity Type:Individual
Prefix:DR
First Name:AWILDA
Middle Name:
Last Name:SANTIAGO-WILSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HALSTED CIR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3184
Mailing Address - Country:US
Mailing Address - Phone:479-878-0016
Mailing Address - Fax:
Practice Address - Street 1:2 HALSTED CIR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3184
Practice Address - Country:US
Practice Address - Phone:479-878-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath