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1629043609
KEITH A WILSON
FORT CAMPBELL, KY
NPI
1629043609
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Former Name
KEITH FOSTER-WILSON
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TN 004702)
Enumeration Date
2006-02-22
Last Update Date
2007-07-08
Business Address
-- KEITH A WILSON LCSW
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8601
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Mailing Address
-- KEITH A WILSON LCSW
PO BOX 40406
NASHVILLE, TN 37204-0406
Phone number: 615-463-6608
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