Individual
SHUNTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5638 PROFESSIONAL CIR, INDIANAPOLIS, IN 46241-5042
(888) 714-1927
Mailing address
2249 GRAND PRIX DR APT A, INDIANAPOLIS, IN 46224-4373
(812) 650-8148
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99126788A
IN
1041C0700X
Clinical Social Worker
99126788A
IN
1041S0200X
School Social Worker
99126788A
IN
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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