Most Relevant Information
Provider Data
| NPI Number: | 1003548546 |
| Provider Name: | KENNETH EDWARD WILSON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | KY3754 |
Most Important Dates
| Enumeration Date: | 06/24/2022 |
| Last Updated: | 06/24/2022 |
Provider Practice Location
2250 LEESTOWN RD
LEXINGTON
KY
405111052
Practice Location Phone/Fax
| Phone: | 8592334511 |
| Fax: | 8592813823 |
Provider Mailing Location
3511 BROOKVIEW DR
LEXINGTON
KY
405171405
Provider Mailing Phone/Fax
| Phone: | 8596842170 |
| Fax: |