Individual
MELISSA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2420 E 10TH ST, JEFFERSONVILLE, IN 47130-7303
(812) 282-8248
(812) 282-3291
Mailing address
2420 E 10TH ST, JEFFERSONVILLE, IN 47130-7303
(812) 282-8248
(812) 282-3291
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33006360A
IN
1041C0700X
Clinical Social Worker
34007117A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200056880A
—
IN
Enumeration date
11/20/2012
Last updated
12/19/2022
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