Individual
SUSAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
318 LAKE MARINA AVE, 212, NEW ORLEANS, LA 70124-1600
(504) 232-8885
Mailing address
318 LAKE MARINA AVE, 212, NEW ORLEANS, LA 70124-1600
(504) 232-8885
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2931
LA
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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