Individual
MS. CATHERINE VIOLET WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTI, R.N.
Contact information
Practice address
1 SAINT VINCENTS DR, SAN RAFAEL, CA 94903-1504
(415) 507-4345
Mailing address
28 CASTLEWOOD DR, SAN RAFAEL, CA 94901-2525
(415) 454-5522
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
51467
CA
101YM0800X
Mental Health Counselor
Primary
51467
CA
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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