Individual
ANYTA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
745 CRAIG RD STE 206, SAINT LOUIS, MO 63141-7122
(314) 282-7501
(314) 432-7500
Mailing address
745 CRAIG RD STE 206, SAINT LOUIS, MO 63141-7122
(314) 282-7501
(314) 432-7500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2000174422
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495349201
—
MO
Enumeration date
03/28/2007
Last updated
07/21/2022
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