Individual
DEVETTA SHAUNTA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6030 MARSHALEE DR STE M114, ELKRIDGE, MD 21075-5987
(443) 591-0202
Mailing address
414 HOWARD MANOR DR, GLEN BURNIE, MD 21060-8260
(443) 591-0202
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC14542
MD
Other
Enumeration date
12/01/2021
Last updated
03/19/2024
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