Individual
JULIE A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
2407 S CAMPBELL AVE, SPRINGFIELD, MO 65807-2903
(417) 812-5525
Mailing address
2407 S CAMPBELL AVE, SPRINGFIELD, MO 65807-2903
(417) 812-5525
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2023026996
MO
Other
Enumeration date
07/26/2023
Last updated
09/12/2023
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