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Organization
WILSON RIDGE LLC
Active
Organization
WILSON RIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN WILSON LPCC (CLINICAL COUNSELOR)
(763) 567-3875
Entity
Organization
Contact information
Practice address
1884 MAHOGANY ST, MORA, MN 55051-7111
(763) 567-3875
Mailing address
7145 375TH AVE NW, DALBO, MN 55017-8403
(763) 567-3877
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/19/2025
Last updated
12/19/2025
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