MS. Theresa Ann Wilson, LCSW

NPI #1295176733 in Polacca, Arizona

Provider Information

NPI Number: 1295176733
Entity Type: Individual
Name: MS. Theresa Ann Wilson, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Jul 12, 2013
Last Updated: Jul 12, 2013

Practice Location

Address: MILEPOST 388 HIGHWAY 264
City: Polacca
State: Arizona
ZIP Code: 86042-4000
Phone: (928) 737-6188

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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