Individual
MACKENZIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 12TH AVE S UNIT 427, NASHVILLE, TN 37204-2444
(904) 669-9130
Mailing address
2310 12TH AVE S UNIT 427, NASHVILLE, TN 37204-2444
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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