Individual
BRANDY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
153 CAMERON WAY CIRCLE, WINSTON SALEM, NC 27103
(706) 483-4683
Mailing address
153 CAMERON WAY CIR, WINSTON SALEM, NC 27103-5943
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P011521
NC
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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