Shannon L Wilson, LCSW
NPI #1013396175 in Mountain Home Afb, Idaho
Provider Information
- NPI Number
- 1013396175
- Entity Type
- Individual
- Name
- Shannon L Wilson, LCSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- May 22, 2015
- Last Updated
- Dec 1, 2025
Practice Location
- Address
- 90 HOPE DR BLDG 6000
- State
- Idaho
- ZIP Code
- 83648-1062
- Phone
- (208) 288-7580
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
| Social Worker |
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