Individual
MICHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. LPCC, LADC
Contact information
Practice address
1132 28TH AVE S, SUITE 102, MOORHEAD, MN 56560-4420
(218) 422-6119
(218) 227-5377
Mailing address
116 E LINCOLN AVE, FERGUS FALLS, MN 56537-2217
(218) 422-6119
(218) 227-5377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303851
MN
101YM0800X
Mental Health Counselor
1520
MN
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/24/2014
Last updated
02/15/2022
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