| NPI | 1669858858 |
|---|---|
| Former Name | ROXANNE ANNESA WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C019948) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2026-04-27 |