Individual
TRICIA R WILSON
Active
Individual
TRICIA R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
05822
IA
1041C0700X
Clinical Social Worker
Primary
05822
IA
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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