Individual
KATHRYN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 HOKE AVE, OCEANSIDE, NY 11572-2910
(151) 699-3213
Mailing address
304 HOKE AVE, OCEANSIDE, NY 11572-2910
(151) 699-3213
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
1041C0700X
Clinical Social Worker
605323121
NY
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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