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Individual
MARY WILSON
Active
Individual
MARY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFTA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3643
CT
106H00000X
Marriage & Family Therapist
Primary
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
01/02/2024
Last updated
11/07/2025
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