Individual
ALICIA LYNN WIMSATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC ASSOCIATE
Contact information
Practice address
620 STONEGLEN DR STE B, KELLER, TX 76248-3625
(817) 562-8800
Mailing address
110 SHADY SPRINGS DR, RUNAWAY BAY, TX 76426-1408
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
90736
TX
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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