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Individual

MS. LISA ELAINE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1052 GARDNER RD STE 700, CHARLESTON, SC 29407-5702
(843) 628-6334
(843) 628-6334
Mailing address
1052 GARDNER RD, SUITE 700, CHARLESTON, SC 29407-5702
(843) 628-6334
(843) 628-6334

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4014
SC

Other

Enumeration date
08/27/2008
Last updated
01/08/2013
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