Wilson, Simone

Wilson, Simone is an individual health care provider with primary practice located at 985 Steeplechase Ln , Riverdale GA 30296-2741. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wilson, Simone can be contacted via phone (562) 619-6129.

Contact Information

Primary practice address
985 Steeplechase Ln Riverdale GA 30296-2741
Phone: (562) 619-6129
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1538752175
LBN Legal business name Wilson, Simone
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2021
Last updated Feb 15th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538752175 NPPES
Georgia MEDICAID 58-1430183

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