Individual
LISA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
160 BEECHWOOD AVE, PAWTUCKET, RI 02860-5402
(401) 722-5573
(401) 726-5571
Mailing address
160 BEECHWOOD AVE, PAWTUCKET, RI 02860-5402
(401) 722-5573
(401) 726-5571
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW01085
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30343
BLUE CROSS CRISIS
RI
01
—
412383
BLUE CHIP CRISIS
RI
05
—
GH57134
—
RI
Enumeration date
06/05/2008
Last updated
04/29/2009
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