Provider Demographics
NPI:1962543918
Name:WILSON, RACHEL ANNE (MSW, LSW, ACSW, QCSW)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ANNE
Last Name:WILSON
Suffix:
Gender:F
Credentials:MSW, LSW, ACSW, QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FULTON DR
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-1013
Mailing Address - Country:US
Mailing Address - Phone:724-941-8068
Mailing Address - Fax:724-941-8068
Practice Address - Street 1:110 FULTON DR
Practice Address - Street 2:
Practice Address - City:VENETIA
Practice Address - State:PA
Practice Address - Zip Code:15367-1013
Practice Address - Country:US
Practice Address - Phone:724-941-8068
Practice Address - Fax:724-941-8068
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW010689L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker