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Individual

MRS. CHRISTIE DELAINE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
521 N. 3RD ST., OLATHE, CO 81425
(970) 252-4684
(970) 323-6117
Mailing address
PO BOX 1208, MONTROSE, CO 81402
(870) 252-3200
(970) 252-3208

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW- 1131
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12148934
CAQH PROVIDER
CO
Enumeration date
11/21/2006
Last updated
03/17/2011
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