Individual
MS. JACQUELINE KATHLEEN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
72 WINTHROP ST, AUGUSTA, ME 04330-5500
(207) 626-3455
(207) 626-7586
Mailing address
72 WINTHROP ST, AUGUSTA, ME 04330-5500
(207) 626-3455
(207) 626-7586
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC13106
ME
Other
Enumeration date
11/02/2011
Last updated
11/10/2013
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