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Individual
MS. TRACY LYNN WILSON
Active
Individual
MS. TRACY LYNN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC, LSW, LICDC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
965776
OH
101YM0800X
Mental Health Counselor
Primary
E0002898
OH
1041C0700X
Clinical Social Worker
S0013519
OH
Other
Enumeration date
09/26/2008
Last updated
09/26/2008
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