Individual
KORTNEY BROOKE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
750 ASTOR AVE FL 2, BRONX, NY 10467-9304
(718) 517-9007
(347) 899-8057
Mailing address
3225 OLINVILLE AVE APT 1G, BRONX, NY 10467-6375
(917) 496-5032
(347) 899-8057
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
41426
NY
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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