Individual
JACQUELINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MH
Contact information
Practice address
1664 E 14TH ST FL 5, BROOKLYN, NY 11229-1155
(646) 265-8074
Mailing address
1664 E 14TH ST FL 5, BROOKLYN, NY 11229-1155
(646) 265-8074
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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