Individual
MR. BRIAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5136 WOOLVERTON AVE, BALTIMORE, MD 21215-5135
(410) 967-6873
Mailing address
5136 WOOLVERTON AVE, BALTIMORE, MD 21215-5135
(410) 967-6873
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
18275
MD
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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