Individual
DWYLA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-S, NCC
Contact information
Practice address
5842 MOHAWK RD, MERIDIAN, MS 39305-1367
(601) 693-1234
(601) 693-1312
Mailing address
5842 MOHAWK RD, MERIDIAN, MS 39305-1367
(601) 693-1234
(601) 693-1312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
246433
MS
101YM0800X
Mental Health Counselor
120
MS
101YM0800X
Mental Health Counselor
Primary
1578
MS
Other
Enumeration date
01/30/2014
Last updated
03/04/2020
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