Individual
EMILY CATHERINE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LBA, BCBA
Contact information
Practice address
9017 FOREST HILL AVE STE 2A, NORTH CHESTERFIELD, VA 23235-3051
(804) 502-4532
Mailing address
7919 WHITWORTH RD, NORTH CHESTERFIELD, VA 23235-4629
(804) 502-4532
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701003037
VA
103K00000X
Behavior Analyst
Primary
1-14-9449
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4947401
—
VA
Enumeration date
02/07/2007
Last updated
05/23/2023
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