Most Relevant Information
Provider Data
| NPI Number: | 1003463704 |
| Provider Name: | LESLIE MARIE WILSON LLBSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 6802090614 |
Most Important Dates
| Enumeration Date: | 08/19/2019 |
| Last Updated: | 08/19/2019 |
Provider Practice Location
19750 BURT RD
DETROIT
MI
482192078
Practice Location Phone/Fax
| Phone: | 3135312500 |
| Fax: |
Provider Mailing Location
38134 LYNDON ST
LIVONIA
MI
481544964
Provider Mailing Phone/Fax
| Phone: | 7348924241 |
| Fax: |