Individual
CARLA SACHIKO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
5555 BOONE AVE N, NEW HOPE, MN 55428-3636
(763) 504-8821
Mailing address
1824 19TH AVE NE, MINNEAPOLIS, MN 55418-4726
(612) 385-1082
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24832
MN
Other
Enumeration date
05/09/2019
Last updated
08/13/2019
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