Individual
JENNIFER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
720 N MARR RD, COLUMBUS, IN 47201-6660
(812) 317-3400
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007378A
IN
Other
Enumeration date
11/10/2015
Last updated
04/06/2017
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