Individual
LYNETTE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.MFT, LMFT
Contact information
Practice address
866 COUNTRY LANE DR, MC GREGOR, TX 76657-9735
(254) 498-2423
Mailing address
866 COUNTRY LANE DR, MC GREGOR, TX 76657-9735
(254) 498-2423
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
201555
TX
Other
Enumeration date
01/17/2014
Last updated
01/17/2014
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