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Individual

MARY SUSAN WILKIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD LPC LMFT

Contact information

Practice address
730 HANNA WOODS DRIVE, CRAMERTON, NC 28032
(504) 236-5642
Mailing address
730 HANNA WOODS DRIVE, CRAMERTON, NC 28032
(504) 236-5642

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
5463NC
NC
101Y00000X
Counselor
LPC1821LA
LA
106H00000X
Marriage & Family Therapist
Primary
MFT299LA
LA

Other

Enumeration date
05/13/2008
Last updated
05/13/2008
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