Individual
GILLIAN LAUREN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
16740 DAVIDSON CONCORD RD, STE 200, DAVIDSON, NC 28036-8746
(704) 801-9200
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12664
NC
101YM0800X
Mental Health Counselor
12664
NC
101YP2500X
Professional Counselor
12664
NC
Other
Enumeration date
11/17/2014
Last updated
05/04/2023
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