Individual
JESSICA ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1116 N 16TH ST, LAFAYETTE, IN 47904-2119
(765) 423-6300
(765) 423-6301
Mailing address
PO BOX 781076, DETROIT, MI 48278-1008
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34009419A
IN
Other
Enumeration date
12/10/2021
Last updated
11/26/2025
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