Individual
TIA LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 E WASHINGTON AVE, UNIT LL, KIRKWOOD, MO 63122-4481
(314) 503-7464
Mailing address
121 E WASHINGTON AVE, UNIT LL, KIRKWOOD, MO 63122-4481
(314) 503-7464
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
2013029980
MO
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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