Individual
CLARICE FARRELL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
987 LENA ST NW, ATLANTA, GA 30314-2921
(630) 251-4068
Mailing address
987 LENA ST NW, ATLANTA, GA 30314-2921
(630) 251-4068
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005920
GA
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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