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Individual
TRACY C WILSON
Active
Individual
TRACY C WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2748
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11643300
CAQH
GA
05
—
844101180A
—
GA
Enumeration date
01/31/2007
Last updated
11/11/2009
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