Individual
TESSA D WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43 E MAIN ST, AMELIA, OH 45102-1993
(513) 947-7000
Mailing address
43 E MAIN ST, AMELIA, OH 45102-1993
(513) 947-7000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1901761
OH
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
LICENSURE BOARD
OH
Enumeration date
01/24/2018
Last updated
04/30/2019
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