Individual
LEATRICE ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-BACS
Contact information
Practice address
2400 CANAL ST, NEW ORLEANS, LA 70119-6535
(504) 356-2678
Mailing address
PO BOX 2678, HARVEY, LA 70059-2678
(504) 356-2678
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12838
LA
Other
Enumeration date
12/30/2020
Last updated
08/29/2024
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