Individual
MRS. JENNIFER LYNN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S., LADC
Contact information
Practice address
510 SE 13TH ST, GRAND RAPIDS, MN 55744-4233
(218) 327-2570
(218) 326-1036
Mailing address
510 SE 13TH ST, GRAND RAPIDS, MN 55744-4233
(218) 327-2570
(218) 326-1036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304574
MN
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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