Individual
LISA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2849B HENDERSON MILL RD, ATLANTA, GA 30341-5772
(647) 902-5472
Mailing address
4680 SAINT JAMES WAY, DECATUR, GA 30035-2248
(678) 902-5472
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC011140
GA
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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