Individual
MINI'IMAH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
15041 CHERRYWOOD DR, LAUREL, MD 20707
(240) 583-0428
Mailing address
15041 CHERRYWOOD DR, LAUREL, MD 20707
(240) 583-0428
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174H00000X
Health Educator
—
—
225C00000X
Rehabilitation Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
09/02/2020
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