Most Relevant Information
Provider Data
| NPI Number: | 1003227299 |
| Provider Name: | CYNTHIA SUE WILSON LISW, CADC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 12005 |
Most Important Dates
| Enumeration Date: | 05/11/2014 |
| Last Updated: | 05/11/2014 |
Provider Practice Location
728 1ST AVE N
FORT DODGE
IA
505010466
Practice Location Phone/Fax
| Phone: | 5155711724 |
| Fax: |
Provider Mailing Location
728 1ST AVE N
FORT DODGE
IA
505010466
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |