Individual
CATHY LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
403 SOUTH HAWTHORNE RD., WINSTON-SALEM, NC 27157-1097
(336) 716-0851
(336) 716-0822
Mailing address
PO BOX 571097, WINSTON-SALEM, NC 27157-1097
(336) 716-0851
(336) 716-0822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C000405
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141EP
BCBS
NC
05
—
6106085
—
NC
01
—
B2046
MEDCOST
NC
Enumeration date
02/26/2007
Last updated
01/18/2008
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