Individual
AMANDA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1621 SCOTTSVILLE RD, BOWLING GREEN, KY 42104-3244
(270) 746-6600
Mailing address
705 RYAN DR, RUSSELLVILLE, KY 42276-1247
(270) 893-3180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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