Organization
WILSON CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RACHEL ANNE WILSON LSW (CEO)
(724) 941-8068
Entity
Organization
Contact information
Practice address
110 FULTON DR, VENETIA, PA 15367-1031
(724) 941-8068
Mailing address
110 FULTON DR, VENETIA, PA 15367-1013
(724) 941-8068
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
SW010689L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1024955450001
PROMISE ID
PA
01
—
SW010689L
LSW STATE LICENSE
PA
Enumeration date
09/23/2016
Last updated
09/23/2016
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