Individual
AMANDA RENEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2118 ADAMS OVERLOOK NW, ATLANTA, GA 30318
(610) 763-3754
Mailing address
2118 ADAMS OVERLOOK NW, ATLANTA, GA 30318-1964
(610) 763-3754
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006515
GA
1041C0700X
Clinical Social Worker
CW018255
PA
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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