Individual
KELLY ANNE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 PYLESVILLE RD, PYLESVILLE, MD 21132-1305
(410) 638-3658
Mailing address
112 PYLESVILLE RD, PYLESVILLE, MD 21132-1305
(410) 638-3658
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21674
MD
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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