NPI | 1952859886 |
---|---|
Former Name | JOANN L. WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2014004873) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2014004873) |
Enumeration Date | 2016-09-20 |
Last Update Date | 2023-11-28 |