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Organization
TRACI WILSON LMFT THERAPY LLC
Active
Organization
TRACI WILSON LMFT THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI WILSON (OWNER)
(916) 397-2443
Entity
Organization
Contact information
Practice address
4305 GESNER ST STE 215, SAN DIEGO, CA 92117-6677
(916) 397-2443
Mailing address
3979 ALABAMA ST, SAN DIEGO, CA 92104-2701
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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