Individual
DAVA R WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1143 FAIRWAY ST STE 320, BOWLING GREEN, KY 42103-2452
(270) 904-6307
(270) 904-6314
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9058
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
253861
KY
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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