Individual
MELISSA DIANE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
4441 KALE PL APT 3, LIHUE, HI 96766
(808) 651-4183
Mailing address
4441 KALE PL APT 3, LIHUE, HI 96766-9168
(808) 651-4183
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT-559
HI
Other
Enumeration date
03/26/2012
Last updated
05/29/2018
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