Individual
CAROLINE ELIZABETH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2553 BEVERLY DR, MOUNTAIN BRK, AL 35223-1115
(407) 670-4880
Mailing address
2553 BEVERLY DR, MOUNTAIN BRK, AL 35223-1115
(407) 670-4880
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
TBD
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12345
N/A
AL
Enumeration date
04/22/2022
Last updated
04/22/2022
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