Individual
JOHANA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 BARBER CREEK DR STE 313, WATKINSVILLE, GA 30677-5996
(229) 425-2763
Mailing address
130 BURGUNDY CT, ATHENS, GA 30601-1376
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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