Individual
VONTRELL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
801 S LEWIS ST, NEW IBERIA, LA 70560-4882
(337) 940-1846
Mailing address
801 S LEWIS ST, NEW IBERIA, LA 70560-4882
(337) 940-1846
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5059
LA
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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