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Individual

ANNIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1010 N PROSPECT ST, BOWLING GREEN, OH 43402-1335
(419) 352-5387
Mailing address
1010 N PROSPECT ST, BOWLING GREEN, OH 43402-1335

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.1700602
OH

Other

Enumeration date
10/06/2017
Last updated
10/06/2017
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