Organization
REVLON WILSON
Active
Other names
No Other Way
Organization subpart
No
Provider details
NPI number
Authorized official
REVLON DIONE WILSON M.A LPC (LICENSED PROFESSIONAL COUNSELOR)
(773) 203-2329
Entity
Organization
Contact information
Practice address
13021 LEGENDARY DR, APT 1334, AUSTIN, TX 78727-3934
(773) 203-2329
Mailing address
13021 LEGENDARY DR, APT 1334, AUSTIN, TX 78727-3934
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
72882
TX
251S00000X
Community/Behavioral Health Agency
Primary
72882
TX
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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