Individual
CRYSTAL ANGELA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8974 162ND ST STE 3, JAMAICA, NY 11432-5012
(718) 526-2400
Mailing address
2232 LORETTA RD FL 2, FAR ROCKAWAY, NY 11691-2537
(917) 808-1050
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10828401
NY
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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