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Individual

BRODIE M WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3656
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3656

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
103451
TX

Other

Enumeration date
09/27/2021
Last updated
09/25/2023
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