Individual
MOLLY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-S
Contact information
Practice address
526 E SECOND ST, PASS CHRISTIAN, MS 39571-4519
(228) 332-1789
Mailing address
526 E SECOND ST, PASS CHRISTIAN, MS 39571-4519
(228) 332-1789
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1083
MS
106H00000X
Marriage & Family Therapist
305
LA
Other
Enumeration date
11/09/2018
Last updated
08/13/2020
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