Individual
MR. MARK OWEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
7125 E US HIGHWAY 36, AVON, IN 46123-7968
(317) 272-2190
(317) 272-2199
Mailing address
7125 E US HIGHWAY 36, AVON, IN 46123-7968
(317) 272-2190
(317) 272-2199
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003687A
IN
Other
Enumeration date
04/04/2007
Last updated
01/11/2012
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