Individual
EBONY N WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LADC
Contact information
Practice address
65 HIGHFIELD DR, TORRINGTON, CT 06790-5826
(860) 626-5002
Mailing address
65 HIGHFIELD DR, TORRINGTON, CT 06790-5826
(860) 626-5002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1267
CT
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
4405
CT
Other
Enumeration date
09/06/2017
Last updated
02/02/2021
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