Individual
SUSAN CLEMENT WILSON
Active
Individual
SUSAN CLEMENT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC, MA, LGC, LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0118861
NM
170300000X
Genetic Counselor (M.S.)
Primary
GC2009-012
NM
Other
Enumeration date
01/23/2009
Last updated
08/07/2009
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