Individual
RYAN PATRICK WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
37 ELIZABETH DR, WESTON, WV 26452-7057
(304) 269-5220
Mailing address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9321
(304) 623-5661
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00943718
WV
Other
Enumeration date
12/11/2018
Last updated
12/11/2018
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