Individual
STEPHANIE H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
227 DONNY BROOK DR, ALLENDALE, NJ 07401-1422
(201) 588-3491
Mailing address
227 DONNY BROOK DR, ALLENDALE, NJ 07401-1422
(201) 588-3491
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00204900
NJ
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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