Individual
ANGELICA NICOLE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
228 PEBBLE CREEK DR, MCDONOUGH, GA 30253-7420
(404) 247-6072
Mailing address
228 PEBBLE CREEK DR, MCDONOUGH, GA 30253-7420
(404) 247-6072
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC009942
GA
101YM0800X
Mental Health Counselor
TPMC1945
FL
101YP2500X
Professional Counselor
068.0136873
VT
101YP2500X
Professional Counselor
0701014644
VA
101YP2500X
Professional Counselor
11278
SC
101YP2500X
Professional Counselor
137077
IA
101YP2500X
Professional Counselor
6401225641
MI
Other
Enumeration date
02/08/2019
Last updated
04/06/2026
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