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Individual
MS. TAMMIE JEAN WILSON
Active
Individual
MS. TAMMIE JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6669
OR
101YM0800X
Mental Health Counselor
LCPC-8690
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500775988
—
OR
Enumeration date
08/03/2019
Last updated
01/15/2026
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