Wilson, Susan

Wilson, Susan is an sole proprietor health care provider with primary practice located at 1931 Horton Rd Ste 3 , Jackson MI 49203-5599. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wilson, Susan can be contacted via phone (734) 425-0396.

Contact Information

Primary practice address
1931 Horton Rd Ste 3 Jackson MI 49203-5599
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6801068911 Michigan

Profile Details

NPI number 1306358247
LBN Legal business name Wilson, Susan
Credentials LMSW, ACSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2017
Last updated Nov 1st, 2017 - about 8 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 1306358247 NPPES
Michigan Other 6801068911 LARA

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