MEDICARE: MRS. JORI A WILSON SOCIAL WORKER

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	1303493	OH

General Provider Information

NPI Number	:	1679432546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JORI A WILSON SOCIAL WORKER

Provider Business Mailing Address
First Line	:	1114 KEIL RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1114 KEIL RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-2736
Country	:	US
Telephone Number	:	419-973-4871
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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