Individual
AMANDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3707 MAIN ST # 5, COLLEGE PARK, GA 30337-3544
(678) 471-9781
Mailing address
4755 ALBANY WAY, ATLANTA, GA 30331-7947
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
10/21/2025
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