Individual
DEBBIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 WHITE ST, MCCOMB, MS 39648-2711
(601) 684-2173
Mailing address
PO BOX 768, MCCOMB, MS 39649-0768
(601) 684-2173
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0778
MS
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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