Individual
BERTHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 JAMES STREET, BUNKIE, LA 71322
(318) 253-3192
Mailing address
313 JAMES STREET, BUNKIE, LA 71322
(318) 253-3192
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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