Individual
MR. KEVIN S WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1970 RIVERSIDE PKWY, ATL VA CBOC, LAWRENCEVILLE, GA 30043-5937
(404) 417-1726
(404) 417-1708
Mailing address
2691 HOLLY SPRINGS DR, SNELLVILLE, GA 30078-5957
(770) 978-7124
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002478
GA
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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