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General NPI Number Information
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NPI Number | 1821108671
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Entity Type | Organization
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Legal Business Name | BARBARA L. WILSON, LCSW, PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 565 UNIVERSITY AVE SUITE 3B
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City | FAIRBANKS
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State | AK
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Zip | 99709-3642
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Country | US
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Telephone | 907-456-3233
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Fax | 907-456-3233
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Provider Business Mailing Address
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Address Line | PO BOX 80042
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City | FAIRBANKS
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State | AK
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Zip | 99708-0042
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Country | US
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Telephone | 907-456-3233
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Fax | 907-456-3233
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA R. WILSON
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Credential | LCSW
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Telephone | 907-456-3233
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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 | 224
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License Number State | AK
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