Individual
IFEANYI C WILLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
183 W APACHE TRL STE B109, APACHE JUNCTION, AZ 85120-3425
(480) 618-0945
Mailing address
PO BOX 746093, ATLANTA, GA 30374-6093
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-15631
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034518
—
AZ
Enumeration date
10/17/2014
Last updated
04/13/2023
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