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NPI Code Detail

MEDICARE: LEAH WILSON LCSW

MEDICARE: LEAH 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
11041C0700XClinical Social Worker54199TX

General Provider Information

NPI Number : 1497148167
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH WILSON LCSW
Provider Business Mailing Address
First Line : 2929 FM 2920 RD
Second Line :
City : SPRING
State : TX
Zip : 77388-3428
Country : US
Telephone Number : 254-498-9086
Fax Number :
Provider Business Practice Location Address
First Line : 2929 FM 2920 RD
Second Line :
City : SPRING
State : TX
Zip : 77388-3428
Country : US
Telephone Number : 254-498-9086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2015
Last Update Date : 04/18/2022

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Directions to “ LEAH WILSON LCSW” Practice Location

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