Individual
CHARLIZE BRIELLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11576 S STATE ST STE 1202A, DRAPER, UT 84020-7119
(385) 365-5881
Mailing address
11576 S STATE ST STE 1202A, DRAPER, UT 84020-7119
(385) 365-5881
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14239643-6009
UT
Other
Enumeration date
06/21/2021
Last updated
10/06/2025
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