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Individual

KELSEY WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW, LISW

Contact information

Practice address
3410 FUTURES DR, SOUTH SIOUX CITY, NE 68776-3917
(402) 412-7242
(712) 252-5920
Mailing address
504 DIVISION ST, JEFFERSON, SD 57038-2039
(712) 898-4800

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
095606
IA
1041C0700X
Clinical Social Worker
Primary
3374
NE

Other

Enumeration date
07/31/2023
Last updated
07/31/2023
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