Individual
SETH HOWARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2055 W NORTHERN AVE, PHOENIX, AZ 85021-5157
(971) 219-8007
Mailing address
301 W PASADENA AVE APT 4, PHOENIX, AZ 85013-2342
(971) 219-8007
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-18808
AZ
104100000X
Social Worker
SC61127538
WA
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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