Individual
MRS. L. JANE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
809 W CHURCH ST, CHAMPAIGN, IL 61820-3320
(217) 373-1850
(217) 373-1856
Mailing address
1398 EAST 2250 NORTH ROAD, WHITE HEATH, IL 61884-0000
(217) 687-4132
(217) 373-1856
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
IL
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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