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Individual

CANDICE WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
900 SHUGART RD, DALTON, GA 30720
(706) 270-5100
(706) 270-5066
Mailing address
51 WILLOWIND LN, RINGGOLD, GA 30736-3281
(423) 682-1453

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YP2500X
Professional Counselor
010346
GA

Other

Enumeration date
04/26/2007
Last updated
09/13/2018
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