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Individual

JILL WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3500 DULUTH PARK LN, SUITE 410, DULUTH, GA 30096-3242
(770) 418-1078
Mailing address
3500 DULUTH PARK LN, SUITE 410, DULUTH, GA 30096-3242
(770) 418-1078

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001627
GA

Other

Enumeration date
04/13/2007
Last updated
07/08/2007
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