Individual
NICOLE R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1423 N JEFFERSON AVE FL 3, SPRINGFIELD, MO 65802-1917
(417) 761-5000
Mailing address
PO BOX 844715, KANSAS CITY, MO 64184-4715
(417) 761-5214
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2024024817
MO
Other
Enumeration date
07/18/2024
Last updated
05/12/2026
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