Individual
MR. ANDREW WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6007 FINANCIAL PLZ STE 213, SHREVEPORT, LA 71129-2638
(318) 458-5158
(318) 220-8108
Mailing address
9817 HADRIANS WAY, SHREVEPORT, LA 71118-4843
(318) 458-5158
(318) 220-8108
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8660
LA
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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