Individual
ANGELA MARIE WILBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 N SAINT ASAPH ST, ALEXANDRIA, VA 22314-1912
(703) 838-4455
Mailing address
12406 WINDBROOK DR, CLINTON, MD 20735-1155
(301) 292-2422
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005722
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188547
ANTHEM
VA
01
—
299045
AMERIGROUP VIRGINIA INC.
VA
01
—
5460011003002
TRICARE
VA
Enumeration date
12/12/2006
Last updated
07/08/2007
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