Individual
KATHLEEN E WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
25 DAIGLE LN STE 101, SANFORD, ME 04073-3961
(207) 619-0852
Mailing address
170 W LEBANON RD, LEBANON, ME 04027-4319
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12516
ME
Other
Enumeration date
08/20/2007
Last updated
03/17/2018
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