Individual
MR. FREDDIE THOMAS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1105 W. PEACHTREE ST., N.E.,, ATLANTA, GA 30309
(404) 853-2832
Mailing address
5254 THE SAVOY, COLLEGE PARK, GA 30349
(404) 853-2832
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW001873
GA
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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