Provider Demographics
NPI:1598073967
Name:WILSON, DONNA E
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:E
Last Name:WILSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 HIDDEN MDW
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4863
Mailing Address - Country:US
Mailing Address - Phone:210-381-4889
Mailing Address - Fax:830-632-4693
Practice Address - Street 1:2122 HIDDEN MDW
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4863
Practice Address - Country:US
Practice Address - Phone:210-381-4889
Practice Address - Fax:830-632-4693
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker