Individual
DONNA JANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
321 W STEPHEN FOSTER AVE, BARDSTOWN, KY 40004-1419
(270) 872-6213
Mailing address
114 PICARDY CT, ELIZABETHTOWN, KY 42701-3132
(270) 872-6213
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3839
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100315100
—
KY
Enumeration date
08/24/2010
Last updated
02/03/2021
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