Individual
MRS. ELISA JULIA THERESA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
51 DEPOT ST, SUITE 209, WATERTOWN, CT 06795-2629
(203) 347-5271
Mailing address
51 DEPOT ST, SUITE 209, WATERTOWN, CT 06795-2629
(203) 347-5271
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006575
CT
Other
Enumeration date
03/17/2008
Last updated
07/05/2011
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