Individual
ROBERT W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2120 S MCCLINTOCK DR, SUITE 105, TEMPE, AZ 85282-2692
(480) 804-0326
(480) 804-0083
Mailing address
1400 E SOUTHERN AVE, STE. 735, TEMPE, AZ 85282-5691
(480) 804-0326
(480) 804-0083
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-10294
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
668301
—
AZ
Enumeration date
12/28/2011
Last updated
04/23/2017
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