Individual
ANDREA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
11801 BUCKEYE RD, CLEVELAND, OH 44120-2620
(216) 831-2255
(216) 378-3906
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255
(216) 378-3906
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.0013941
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0268768
—
OH
Enumeration date
02/17/2011
Last updated
02/17/2011
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