Individual
CASEY GROVER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
20311 CENTRAL AVE W, BLOUNTSTOWN, FL 32424-1947
(850) 674-8888
Mailing address
4878 DOGWOOD DR, MARIANNA, FL 32446-8163
(850) 510-0823
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
FL
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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