Individual
DANIELLE RAE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
72351 PINE RIVER RD, WILLOW RIVER, MN 55795-3120
(218) 372-3801
Mailing address
19499 SILVER FOX DR, PINE CITY, MN 55063-5041
(651) 354-3057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25981
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25981
—
MN
Enumeration date
02/24/2020
Last updated
02/24/2020
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