Individual
DR. DEBORAH MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, EDD
Contact information
Practice address
1227 AUGUSTA WEST PKWY, 8, AUGUSTA, GA 30909-6670
(706) 825-8472
(706) 825-9051
Mailing address
1227 AUGUSTA WEST PKWY, SUITE 8, AUGUSTA, GA 30909-6670
(706) 825-8472
(706) 825-9051
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
18226
TX
101YP2500X
Professional Counselor
6401013511
MI
101YP2500X
Professional Counselor
Primary
LPC004458
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172613501
—
TX
05
—
184952006A
—
GA
Enumeration date
08/14/2006
Last updated
02/05/2014
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