Individual
MS. JOYCE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
677A EAST MAIN, CENTREVILLE, MI 49032
(269) 467-1000
(269) 467-3075
Mailing address
677A EAST MAIN, CENTREVILLE, MI 49032
(269) 467-1000
(269) 467-3075
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401009453
MI
103T00000X
Psychologist
6301007523
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1708146
—
MI
Enumeration date
09/14/2006
Last updated
07/22/2009
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