Individual
DONTIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7510
Mailing address
PO BOX 92, TAYLOR, MI 48180-0092
(419) 508-9566
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MI
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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