Individual
RENEE TANYA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
5535 HARVARD RD, DETROIT, MI 48224-2163
(313) 434-0163
Mailing address
5535 HARVARD RD, DETROIT, MI 48224-2163
(313) 434-0163
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401014386
MI
Other
Enumeration date
06/26/2016
Last updated
06/26/2016
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