Individual
LAUREL ANN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 RIVER AVE, EUGENE, OR 97404-2507
(541) 607-7547
Mailing address
2527 AGATE ST, EUGENE, OR 97403-1684
(541) 505-7436
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-25275
ID
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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