Doctor Name: | LAMONTE GARNETT WILSON |
NPI Number: | 1649257346 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | QI-0000548 |
Business Practice Address: | 300 Tuskegee Blvd Dover Afb, DE - 199025300 |
Business Phone Number: | 3026773910 |
Business Fax Number: | |
Mailing Address: | 23 Airdrie Dr, BEAR |
State: | DE |
Postal Code: | 197012361 |
Phone Number: | 3023995773 |
Fax Number: | |
NPI Enumeration Date: | 12/23/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | QI-0000548 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |