Mark Owen Wilson, M.S.W., L.C.S.W.
Social Worker, Clinical in Avon, IN. Individual provider (NPI-1).
NPI number1598887366
StatusActive
Last updated in NPPESJan 11, 2012
Details
- NPI
- 1598887366
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mark Owen Wilson
- Credential
- M.S.W., L.C.S.W.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2007
- Last updated
- Jan 11, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34003687A | IN | Yes |
Other names
- Mark Owen Belue Wilson (Professional Name)
Practice location
7125 E Us Highway 36Avon, IN 46123-7968
Phone 317-272-2190 · Fax 317-272-2199
Mailing address
7125 E Us Highway 36Avon, IN 46123-7968
Phone 317-272-2190 · Fax 317-272-2199
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