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Individual

MRS. LOREE ANN WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A./PPS/APCC

Contact information

Practice address
5213 EL MERCADO PKWY STE A, SANTA ROSA, CA 95403-1301
(707) 571-1714
Mailing address
1000 YULUPA AVE, SANTA ROSA, CA 95405-7020

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
948
CA
101YS0200X
School Counselor
Primary
160255235
CA

Other

Enumeration date
02/25/2013
Last updated
03/17/2018
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