Individual
LAURA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSW
Contact information
Practice address
16913 KNOBLEY RD, BURLINGTON, WV 26710
(304) 289-3696
Mailing address
539 NEW CREEK HWY, KEYSER, WV 26726-8215
(304) 813-2884
(304) 788-2409
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CP00943189
WV
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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