Individual
ALLISON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3048 E BASELINE RD STE 117, MESA, AZ 85204-7288
(801) 609-1379
Mailing address
14818 S 13TH PL, PHOENIX, AZ 85048-6211
(501) 286-2938
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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