Individual
ANGELA RENEE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3 CUSUMANO PROFESSIONAL PLAZA DR, MOUNT VERNON, IL 62864-6736
(618) 267-3968
Mailing address
829 OAKLAND AVE, MOUNT VERNON, IL 62864-3526
(618) 267-3968
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.016894
IL
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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