Individual
WANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
51 N ST NE, WASHINGTON, DC 20002-3347
(202) 442-6077
Mailing address
6503 LACONA ST, FORESTVILLE, MD 20747-2882
(301) 735-4838
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC302836
DC
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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