Individual
WILSON SHADWELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 MALLARD COURT, BECKLEY, WV 25801
(304) 255-7526
Mailing address
1565 PLUTO ROAD, SHADY SPRING, WV 25918
(304) 719-9144
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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