Individual
DAWN MARCELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1358 E RICHARDS ST, TYLER, TX 75702-6153
(903) 595-5525
(903) 531-9328
Mailing address
PO BOX 1238, TYLER, TX 75710-1238
(903) 595-5525
(903) 531-9328
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
69032
TX
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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