Individual
WILBERT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30826 LINDER RD, DENHAM SPRINGS, LA 70726-8507
(225) 239-5426
Mailing address
21033 PINE KNOT LN, LAND O LAKES, FL 34637-7827
(225) 239-7830
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
14535
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/28/2018
Last updated
01/20/2023
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