Doctor Name: | REBECCA A WILSON |
NPI Number: | 1679875025 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW-S |
License Number: | OH3179174 |
Business Practice Address: | 955 Cherry St Blanchester, OH - 451077907 |
Business Phone Number: | 9377833642 |
Business Fax Number: | |
Mailing Address: | 955 Cherry St, BLANCHESTER |
State: | OH |
Postal Code: | 451077907 |
Phone Number: | 9377833642 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2010 |
NPI Last Update Date: | 09/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | OH3179174 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |