Individual
LORI SUE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISAC
Contact information
Practice address
2480 N PALO VERDE BLVD, #103, TUCSON, AZ 85716-2548
(520) 322-6980
Mailing address
7464 S NEVIL DR, TUCSON, AZ 85746-2565
(520) 883-6105
(520) 883-6105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11771
AZ
Other
Enumeration date
02/04/2008
Last updated
02/04/2008
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