Individual
MR. JEREMY SHANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW, LSW
Contact information
Practice address
5400 EDALBERT DR, CINCINNATI, OH 45239-7604
(859) 536-5808
(513) 741-5686
Mailing address
5400 EDALBERT DR, CINCINNATI, OH 45239-7604
(513) 741-3100
(513) 741-5686
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1000131
OH
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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