Individual
DR. KIMBERLY M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NMD,LPC,LMFT, LCDC,L
Contact information
Practice address
2942 N 24TH ST, #114-545, PHOENIX, AZ 85016
(888) 539-1233
(469) 606-9102
Mailing address
712 MASON DR, VIRTUAL SERVICES ONLY, ALLEN, TX 75013
(888) 539-1233
(469) 606-9102
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15525
TX
101YM0800X
Mental Health Counselor
84153
TX
106H00000X
Marriage & Family Therapist
203984
TX
133N00000X
Nutritionist
071039
AZ
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
175F00000X
Naturopath
Primary
07-1039
AZ
175L00000X
Homeopath
071039
AZ
176B00000X
Midwife
—
—
225700000X
Massage Therapist
MI3923
TX
374J00000X
Doula
—
—
376K00000X
Nurse's Aide
—
TX
Other
Enumeration date
01/22/2008
Last updated
01/09/2024
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