Individual
MS. REGINA ANGELA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
277 W PARKER ST, OZARK, AL 36360-1248
(334) 774-4791
Mailing address
277 W PARKER ST, OZARK, AL 36360-1248
(334) 774-4791
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4394G
AL
Other
Enumeration date
01/22/2020
Last updated
03/05/2021
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