Individual
MS. JANE EDITH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8330 LANKERSHIM BLVD, NORTH HOLLYWOOD, CA 91605-1615
(818) 994-7454
Mailing address
17412 VENTURA BLVD, #820, ENCINO, CA 91316-3827
(818) 267-4058
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
ASW119362
CA
Other
Enumeration date
01/14/2015
Last updated
01/10/2024
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