Individual
MRS. DIERDRE RYLENE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
4600 MONTGOMERY BLVD NE STE B203, ALBUQUERQUE, NM 87109-1202
(505) 421-0814
Mailing address
4600 MONTGOMERY BLVD NE STE B203, ALBUQUERQUE, NM 87109-1202
(505) 421-0814
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0162741
NM
101YP2500X
Professional Counselor
Primary
0190311
NM
Other
Enumeration date
06/29/2010
Last updated
11/02/2022
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