Individual
MARIETTA C WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5768 S SEMORAN BLVD, ORLANDO, FL 32822-4818
(321) 397-3000
(321) 397-3024
Mailing address
4017 DIJON DR, ORLANDO, FL 32808-2277
(201) 687-6331
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/29/2022
Last updated
01/07/2025
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