Individual
REGINA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
135 N GREENLEAF ST STE 120, GURNEE, IL 60031-3334
(224) 285-0728
Mailing address
135 N GREENLEAF ST STE 120, GURNEE, IL 60031-3334
(224) 430-8109
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW010067
GA
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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