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Individual

MRS. ANGELA RENEE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, NCC

Contact information

Practice address
201 W SPRINGFIELD AVE, SUITE 1005, CHAMPAIGN, IL 61820-6385
(217) 693-4913
Mailing address
501 EDWARDS CT, MONTICELLO, IL 61856-2277
(217) 762-7980

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178011253
IL

Other

Enumeration date
09/11/2015
Last updated
03/16/2016
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