Individual
REBECCA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
7649 WOODCREST ST, PORTAGE, MI 49024-5059
(269) 385-8516
(269) 385-6004
Mailing address
7649 WOODCREST ST, PORTAGE, MI 49024-5059
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401007862
MI
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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