Individual
JAMESIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
(601) 321-2476
Mailing address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
(601) 321-2476
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
W7331
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018209
—
MS
Enumeration date
02/11/2011
Last updated
02/11/2011
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