Individual
NINA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 S 4TH ST, LOUISVILLE, KY 40203-3207
(502) 708-8227
Mailing address
PO BOX 35, STOCKBRIDGE, GA 30281-0035
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
07/05/2019
Last updated
07/05/2019
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