| NPI | 1720633852 |
|---|---|
| Former Name | CAITLYN WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2021-08-17 |