Individual
MR. GEORGE MARC WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1815 PLEASANT GROVE RD, JONESBORO, AR 72401
(870) 933-6886
(870) 933-9395
Mailing address
1425 W MAIN ST, WALNUT RIDGE, AR 72476-1431
(870) 886-5303
(870) 886-7002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2210-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174440795
—
AR
01
—
5A755
BCBS
AR
Enumeration date
01/08/2008
Last updated
07/09/2018
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