MEDICARE: MS. TASIA ROSHAY WILSON P.L.P,C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor		LA

General Provider Information

NPI Number	:	1760854780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TASIA ROSHAY WILSON P.L.P,C

Provider Business Mailing Address
First Line	:	215 BRES AVE
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5860
Country	:	US
Telephone Number	:	318-509-8073
Fax Number	:

Provider Business Practice Location Address
First Line	:	4315 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-9661
Country	:	US
Telephone Number	:	225-223-6968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2015
Last Update Date	:	02/03/2026

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