Individual
TRACY LOUISE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPCC
Contact information
Practice address
300 W BROADWAY ST STE 2, MISSOULA, MT 59802-4126
(406) 531-1042
Mailing address
PO BOX 17491, MISSOULA, MT 59808-7491
(406) 531-1042
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
62548
MT
Other
Enumeration date
03/08/2023
Last updated
03/24/2023
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