Individual
DAVID NICHOLAS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2419 E HAZZARD ST, PHILADELPHIA, PA 19125-3112
(703) 999-6632
Mailing address
2419 E HAZZARD ST, PHILADELPHIA, PA 19125-3112
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW024013
PA
Other
Enumeration date
10/14/2020
Last updated
10/13/2023
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