Individual
MS. MARY JANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
241 WRIGHT ST, MARQUETTE, MI 49855-1955
(906) 228-7611
Mailing address
114 BASAL RD, MARQUETTE, MI 49855-9202
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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