Individual
KRISTINA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
15 UNION ST, MILFORD, NH 03055-4875
(603) 672-6279
Mailing address
614 NASHUA ST, PMB 173, MILFORD, NH 03055-4943
(603) 672-6279
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
740
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40421090
—
NH
Enumeration date
02/16/2007
Last updated
07/09/2007
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