| Doctor Name: | MRS. DEANNA M WILSON |
| NPI Number: | 1124123484 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | C005679 |
| Business Practice Address: | 853 Wake Forest Business Park Ste D Wake Forest, NC - 275876519 |
| Business Phone Number: | 9193957110 |
| Business Fax Number: | |
| Mailing Address: | 3650 Rogers Rd, #236 WAKE FOREST |
| State: | NC |
| Postal Code: | 275879306 |
| Phone Number: | 9193957110 |
| Fax Number: | |
| NPI Enumeration Date: | 09/13/2006 |
| NPI Last Update Date: | 02/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | C005679 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |