Individual
JENNIFER KAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7356
(651) 232-7696
Mailing address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 232-7356
(651) 232-7696
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13762
MN
Other
Enumeration date
02/09/2009
Last updated
02/09/2009
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