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General NPI Number Information
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NPI Number | 1093916264
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Entity Type | Individual
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Provider Name | MARQUITA D. WILSON LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 7701 SEVEN MILE LN
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City | PIKESVILLE
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State | MD
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Zip | 21208-4326
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Country | US
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Telephone | 410-887-1207
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Fax | 410-887-1259
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Provider Business Mailing Address
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Address Line | 7924 LANSDALE RD
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City | BALTIMORE
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State | MD
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Zip | 21224-2121
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Country | US
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Telephone | 443-691-1929
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Fax | 410-887-1259
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14431
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | G11181
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License Number State | MD
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