Individual
KRISTA JULIANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TCADC
Contact information
Practice address
805 COMMERCE DR, LEITCHFIELD, KY 42754-9188
(270) 259-4652
Mailing address
805 COMMERCE DR, LEITCHFIELD, KY 42754-9188
(270) 259-4652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
287527
KY
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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