| NPI | 1538487541 |
|---|---|
| Former Name | AMY MICHELLE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 64157) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 64157) |
| 101YP2500X Counselor, Professional (Licence: TX 64157) | |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2023-02-10 |