Ruth A Wilson, LICSW

Individual provider Active NPI Social Worker · Bolton, MA

NPI 1811065097 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1811065097
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
1017004 (MA)
Practice address
563 Main Street
Bolton, MA 01740-1300
Phone
(978) 779-6505
Fax
(978) 779-0211
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1017004MAMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1017004 MA Yes

Addresses

Primary practice location

563 Main Street
Bolton, MA 01740-1300

Mailing address

563 Main Street
Bolton, MA 01740-1300
Phone (978) 779-6505

Other providers in Bolton, MA

All providers in Bolton, MA · Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.