| NPI | 1952640831 |
|---|---|
| Former Name | WANDA L WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID 45394) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-45394) |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2025-06-25 |