Individual
KOURTNEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1025 HERMOSA DR SE, ALBUQUERQUE, NM 87108-4312
(505) 237-0061
Mailing address
1025 HERMOSA DR SE, ALBUQUERQUE, NM 87108-4312
(505) 237-0061
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0218491
NM
Other
Enumeration date
08/22/2021
Last updated
08/22/2021
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