Provider Demographics
NPI:1093985855
Name:WILSON, ROBIN ANGELA (MSW, BSW,)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ANGELA
Last Name:WILSON
Suffix:
Gender:F
Credentials:MSW, BSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:VANCEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28586-8626
Mailing Address - Country:US
Mailing Address - Phone:252-244-1840
Mailing Address - Fax:
Practice Address - Street 1:170 HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:VANCEBORO
Practice Address - State:NC
Practice Address - Zip Code:28586-8626
Practice Address - Country:US
Practice Address - Phone:252-244-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical