Individual
MS. STACEY JANETTE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
235 MICHIGAN AVENUE, CARY, NC 27519
(832) 867-6767
Mailing address
235 MICHIGAN AVENUE, CARY, NC 27519
(832) 867-6767
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
12115A
NC
Other
Enumeration date
09/01/2018
Last updated
09/01/2018
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