License Detail

NameWILSON OWENS KIM W
AddressMT VERNONNY
ProfessionLICENSED CLINICAL SOCIAL WORK
License No027341
Date of Licensure09/01/04  (OriginallylicensedasaCertifiedSocialWorkeron12/31/81)
Additional QualificationP -3-year psychotherapy privilege
StatusREGISTERED
Registered through last day of

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