Individual
SUSAN FAITH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1555 BRAE MOOR LN, DUNEDIN, FL 34698-3212
(727) 547-5200
(727) 940-6073
Mailing address
1555 BRAE MOOR LN, DUNEDIN, FL 34698-3212
(727) 504-3008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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