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Individual
SAMANTHA WILSON
Active
Individual
SAMANTHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12338809-3501
UT
1041C0700X
Clinical Social Worker
77713494
ID
1041C0700X
Clinical Social Worker
7771394
ID
Other
Enumeration date
01/26/2026
Last updated
07/23/2026
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