Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 PITT ST, MOUNT PLEASANT, SC 29464-5319
(843) 323-0693
Mailing address
1014 BENNINGTON DR, CHARLESTON, SC 29492-8473
(843) 614-1774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
COU.8380
SC
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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