Individual
ANDRIA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC-MHSP, CET1
Contact information
Practice address
4646 POPLAR AVE STE 519, MEMPHIS, TN 38117-4435
(901) 401-0198
(901) 231-7594
Mailing address
4646 POPLAR AVE STE 519, MEMPHIS, TN 38117-4435
(901) 401-0198
(901) 231-7594
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4456
TN
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
04/27/2010
Last updated
05/20/2021
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