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1356464556
STACY MICHELLE WILSON
BENTONVILLE, AR
NPI
1356464556
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AR 2075-C)
Enumeration Date
2007-04-10
Last Update Date
2007-07-08
Business Address
Ms. STACY MICHELLE WILSON LCSW
2003 SE WALTON BLVD
BENTONVILLE, AR 72712-3725
Phone number: 479-464-8081
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Mailing Address
Ms. STACY MICHELLE WILSON LCSW
4253 N CROSSOVER RD
FAYETTEVILLE, AR 72703-4593
Phone number: 479-521-5731
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