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Individual
HEATHER WILSON
Active
Individual
HEATHER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C012252
NC
1041S0200X
School Social Worker
22040
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790218915
—
NC
Enumeration date
04/05/2017
Last updated
11/25/2020
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