Individual
ANGEL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC #32962
Contact information
Practice address
335 E WOOD ST STE B, DECATUR, IL 62523-1431
(217) 422-6908
(217) 422-7103
Mailing address
335 E WOOD ST STE B, DECATUR, IL 62523-1431
(217) 422-6908
(217) 422-7103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32962
IL
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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