MEDICARE: MS. MARGARET A WILSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34004880A	IN

General Provider Information

NPI Number	:	1427180181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET A WILSON LCSW

Provider Business Mailing Address
First Line	:	15832 SYMPHONY BLVD
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-4295
Country	:	US
Telephone Number	:	317-506-7705
Fax Number	:	317-781-0465

Provider Business Practice Location Address
First Line	:	5218 S EAST ST
Second Line	:	SUITE E-4
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-1900
Country	:	US
Telephone Number	:	317-506-7705
Fax Number	:	317-781-0465

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	07/08/2007

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