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Individual

MS. KATHY M.O. WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, MFTI, LADCI

Contact information

Practice address
550 CALIFORNIA AVE, RENO, NV 89509-1450
(775) 355-7722
(775) 355-7116
Mailing address
PO BOX 1782, SPARKS, NV 89432-1782
(775) 240-1796
(775) 355-7116

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC-I 00043
NV
106H00000X
Marriage & Family Therapist
Primary
MI0312
NV

Other

Enumeration date
11/02/2012
Last updated
11/02/2012
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