Individual
MS. BENITA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,NCC,LMHC,LPC
Contact information
Practice address
8528 GOLF RIDGE DR, CHARLOTTE, NC 28277-8836
(917) 686-6406
Mailing address
8528 GOLF RIDGE DR, CHARLOTTE, NC 28277-8836
(917) 686-6406
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000042
NY
101YP2500X
Professional Counselor
7640
NC
Other
Enumeration date
07/26/2006
Last updated
10/11/2012
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