Individual
ALEXANDRA MARIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
601 PERRYVILLE DR BLDG 22, PERRY POINT, MD 21902-1111
(410) 642-2411
Mailing address
10 N GREENE ST, BALTIMORE, MD 21201-1524
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
28237
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841744232
—
MD
Enumeration date
04/09/2022
Last updated
03/30/2023
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