Individual
SHELBY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4929 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 871-6122
Mailing address
2410 W FINN PL, MILWAUKEE, WI 53206-1338
(414) 324-2376
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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