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Individual
LATOYA SHENA WILSON
Active
Individual
LATOYA SHENA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-30953
NC
1041C0700X
Clinical Social Worker
Primary
P021341
NC
175T00000X
Peer Specialist
P021341
NC
251B00000X
Case Management Agency
P021341
NC
251S00000X
Community/Behavioral Health Agency
P021341
NC
Other
Enumeration date
04/23/2025
Last updated
03/11/2026
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