# MELISSA WILSON LMFT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831814284
- **Authorized official:** MELISSA DIANE WILSON LMFT (OWNER/ PROVIDER)
- **Authorized official phone:** (808) 651-4183

## Contact information

- **Practice address:** 4374 KUKUI GROVE ST STE 102, LIHUE, HI 96766-2007
- **Practice address phone:** (808) 651-4183
- **Mailing address:** 3877D OMAO RD, KOLOA, HI 96756-9615
- **Mailing address phone:** (808) 651-4183

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2022
- **Last updated:** 11/02/2022