Individual
HEIDI WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBA, MA, LPC, CACII
Contact information
Practice address
1137 PEARL ST, SUITE 207, BOULDER, CO 80302-5159
(720) 530-8227
(303) 927-6016
Mailing address
1630 30TH ST STE A, PMB 217, BOULDER, CO 80301-1045
(720) 530-8227
(303) 927-6016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6191
—
101YP2500X
Professional Counselor
Primary
4075
—
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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