Individual
MRS. DEANNA M WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
853 WAKE FOREST BUSINESS PARK STE D, WAKE FOREST, NC 27587-6519
(919) 395-7110
Mailing address
3650 ROGERS RD, #236, WAKE FOREST, NC 27587-9306
(919) 395-7110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005679
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6007315
—
NC
Enumeration date
09/13/2006
Last updated
02/04/2011
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