Provider Demographics
NPI:1972313500
Name:WILSON, CELINA (CPT)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:WILSON
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 1:11427 REED HARTMAN HWY
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2418
Mailing Address - Country:US
Mailing Address - Phone:513-927-2095
Mailing Address - Fax:
Practice Address - Street 1:11427 REED HARTMAN HWY
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45241-2418
Practice Address - Country:US
Practice Address - Phone:513-927-2095
Practice Address - Fax:513-927-2097
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHN24111687246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty