Individual
AIMEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1860 E GIBBONS ST, BARTOW, FL 33830-6711
(321) 300-4399
Mailing address
1066 BLACKWOLF RUN RD, CHAMPIONS GATE, FL 33896-7950
(321) 697-6269
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH14655
FL
101YM0800X
Mental Health Counselor
Primary
MH16300
FL
Other
Enumeration date
02/02/2018
Last updated
07/24/2021
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