Individual
SUSAN REESE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2868 ACTON ROAD, BIRMINGHAM, AL 35243
(205) 968-8360
(205) 968-8373
Mailing address
956 MONTCLAIR ROAD, SUITE 200, BIRMINGHAM, AL 35213
(205) 949-4540
(205) 949-4541
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1805C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51531010
BCBS
AL
Enumeration date
05/24/2006
Last updated
07/08/2007
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