Individual
DORIS GARDNER-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCDC
Contact information
Practice address
14825 SAINT MARYS LN STE 122, HOUSTON, TX 77079-2989
(832) 489-1998
Mailing address
6539 HOLLOW OAKS DR STE F, HOUSTON, TX 77050-3717
(823) 489-1998
(713) 589-4730
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
9650
TX
104100000X
Social Worker
58672
TX
1041C0700X
Clinical Social Worker
Primary
58672
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13255920
TEXAS DRIVERS LICENSE
TX
Enumeration date
12/16/2013
Last updated
01/25/2023
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