Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, NCC
Contact information
Practice address
224 TWIN LAKES RD, SOMERSET, PA 15501-7727
(814) 443-3639
Mailing address
224 TWIN LAKES RD, SOMERSET, PA 15501-7727
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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