Wilson, Janice Susan
Wilson, Janice Susan is an sole proprietor health care provider with primary practice located at 300 W 2Nd St , Roswell NM 88201-4600. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Wilson, Janice Susan can be contacted via phone (505) 624-2661.Contact Information
Primary practice address
300 W 2Nd St
Roswell NM 88201-4600
Phone: (505) 624-2661
Fax: (505) 625-0643
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | I-05660 | New Mexico |
Profile Details
| NPI number | 1700970431 |
|---|---|
| LBN Legal business name | Wilson, Janice Susan |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700970431 | NPPES |
| New Mexico | MEDICAID | 17104815 |
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