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General NPI Number Information
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NPI Number | 1154630879
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Entity Type | Individual
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Provider Name | DAWN WALTON WILSON MSW, ACSW, LCSW, NSW
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Gender | Female
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Dates
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Enumeration Date | 09/29/2010
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 2708 POTTS CREED RD.
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City | COVINGTON
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State | VA
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Zip | 24426
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Country | US
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Telephone | 540-747-2495
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 921
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City | COVINGTON
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State | VA
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Zip | 24426-0921
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Country | US
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Telephone | 540-747-2495
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Fax | 540-747-2789
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0904003169
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License Number State | VA
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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 | CP00941017
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License Number State | WV
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