Individual
MRS. LISA JEAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRC
Contact information
Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-1653
(501) 257-1671
Mailing address
1660 IVY CV, CONWAY, AR 72034-8406
(501) 548-1237
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
42922
AR
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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