Individual
JEANINE MICHELLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4809 COLONEL BROOKE CT, UPPER MARLBORO, MD 20772-2872
(410) 507-8183
(301) 780-3271
Mailing address
4809 COLONEL BROOKE CT, UPPER MARLBORO, MD 20772-2872
(410) 507-8183
(301) 780-3271
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC50078965
DC
Other
Enumeration date
03/22/2011
Last updated
03/22/2011
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