Individual
KRISTY JAY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
144 PIERCE AVE, MACON, GA 31204-2860
(478) 475-4608
(478) 476-8397
Mailing address
717 NORTH AVENUE, MACON, GA 31211-1418
(478) 475-4608
(478) 476-8397
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000813
GA
Other
Enumeration date
03/25/2019
Last updated
05/14/2026
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