Individual
JACQUELYN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 YORK RD STE 216, TIMONIUM, MD 21093-2276
(443) 202-7736
Mailing address
221 LUBERTHA RD, RIDGELAND, MS 39157-5070
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
31047
MD
1041C0700X
Clinical Social Worker
M9984
MS
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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