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Individual

MRS. CRYSTAL MARIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
22C E NEWNAN RD, NEWNAN, GA 30263-2230
(803) 616-4095
Mailing address
1450 NEWNAN CROSSING BLVD E APT 4213, NEWNAN, GA 30265-0010
(803) 616-4095

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW006581
GA

Other

Enumeration date
12/26/2018
Last updated
10/19/2020
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