Mary Ann Wilson, LCSW-R
Social Worker, Clinical in Penfield, NY. Individual provider (NPI-1).
NPI number1760664338
StatusActive
Last updated in NPPESJan 13, 2025
Details
- NPI
- 1760664338
- Entity type
- Individual (NPI-1)
- Name
- Mary Ann Wilson
- Credential
- LCSW-R
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 5, 2007
- Certification date
- Dec 31, 2024
- Last updated
- Jan 13, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 072055 | NY | Yes |
Practice location
2130 Five Mile Line RdPenfield, NY 14526-2292
Phone 585-690-0890
Mailing address
2130 Five Mile Line RdPenfield, NY 14526-2292
Phone 585-690-0890
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