Individual
MS. CORRINE MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1415 PORTLAND AVE STE 400, ROCHESTER, NY 14621-3022
(585) 922-3653
(585) 922-4200
Mailing address
1415 PORTLAND AVE STE 400, ROCHESTER, NY 14621-3022
(585) 922-3653
(585) 922-4200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
079034
NY
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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