Individual
KANDIS-AYANNA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4144 LINDELL BLVD STE 319, SAINT LOUIS, MO 63108-2953
(314) 964-6555
Mailing address
4144 LINDELL BLVD STE 319, SAINT LOUIS, MO 63108-2953
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2022021048
MO
Other
Enumeration date
03/20/2023
Last updated
01/28/2025
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