Theresa Ann Wilson LCSW

NPI 1295176733 - Social Worker - 1041C0700X

NPI Details
NPI 1295176733
Gender Female
Enumeration Date 07/12/2013
Last Updated 07/12/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
MILEPOST 388 HIGHWAY 264
POLACCA AZ, 86042-4000, US
Phone (928) 737-6188
Fax (928) 737-6098
Business Location
PO BOX 4000
POLACCA AZ, 86042-4000, US
Phone (928) 737-6188
Fax (928) 737-6098
Toxanomy
Taxonomy Code 1041C0700X
License State New York
License Number 0698081
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According to our database, Ms. Theresa Ann Wilson LCSW NPI is 1295176733, taxonomy code is 1041C0700X and license number is 0698081, license state is located at New York. Theresa Ann Wilson LCSW physically located at Milepost 388 Highway 264, Polacca AZ, 86042-4000. NPI Number Theresa Ann Wilson LCSW has the Individual type.

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1295176733 NPI number is provided on an as is basis without warranty of any kind. 1295176733 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa Ann Wilson LCSW are for informational purposes only.