Anthony Jerome Wilson LCSW

NPI 1790920296 - Social Worker - 1041C0700X

NPI Details
NPI 1790920296
Gender Male
Enumeration Date 12/11/2008
Last Updated 12/11/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1625 DAVID RAINES RD
SHREVEPORT LA, 71107-5899, US
Phone (318) 425-2252
Fax (318) 227-3357
Business Location
1625 DAVID RAINES RD
SHREVEPORT LA, 71107-5899, US
Phone (318) 425-2252
Fax (318) 227-3357
Toxanomy
Taxonomy Code 1041C0700X
License State Louisiana
License Number 1294
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According to our database, Mr. Anthony Jerome Wilson LCSW NPI is 1790920296, taxonomy code is 1041C0700X and license number is 1294, license state is located at Louisiana. Anthony Jerome Wilson LCSW physically located at 1625 David Raines Rd, Shreveport LA, 71107-5899. NPI Number Anthony Jerome Wilson LCSW has the Individual type.

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1790920296 NPI number is provided on an as is basis without warranty of any kind. 1790920296 is maintained by the National Plan & Provider Enumeration System. The contents of Anthony Jerome Wilson LCSW are for informational purposes only.