Individual
RHIANNON LOUISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CCSS
Contact information
Practice address
12836 LOMAS BLVD NE STE C, ALBUQUERQUE, NM 87112-6200
(505) 710-6530
Mailing address
12836 LOMAS BLVD NE STE C, ALBUQUERQUE, NM 87112-6200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C-11961
NM
1041C0700X
Clinical Social Worker
C-11961
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41382048
—
NM
Enumeration date
08/26/2010
Last updated
01/10/2025
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