Individual
KASEY J. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
5701 EXECUTIVE CENTER DR, SUITE 100, CHARLOTTE, NC 28212-8862
(704) 563-4103
(704) 563-4112
Mailing address
5701 EXECUTIVE CENTER DR, SUITE 100, CHARLOTTE, NC 28212-8862
(704) 563-4103
(704) 563-4112
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
11618
NC
Other
Enumeration date
09/23/2010
Last updated
09/25/2015
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