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Organization
CHART YOUR COURSE THERAPEUTIC SERVICES
Active
Organization
CHART YOUR COURSE THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA WILSON LPCC (THERAPIST)
(763) 273-0671
Entity
Organization
Contact information
Practice address
6900 IVES LN N, MAPLE GROVE, MN 55369-5414
(763) 670-2289
Mailing address
6900 IVES LN N, MAPLE GROVE, MN 55369-5414
(763) 670-2289
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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