Individual
MYSHALA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
360 MAIN ST STE 2D, MIDDLETOWN, CT 06457-3375
(860) 248-6046
(844) 264-0237
Mailing address
360 MAIN ST STE 2D, MIDDLETOWN, CT 06457-3375
(203) 449-6399
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
004997
CT
Other
Enumeration date
02/01/2022
Last updated
02/07/2022
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