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Individual

MS. SHANNON MARIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC, CRC, CADC

Contact information

Practice address
1570 42ND ST NE STE 2A, CEDAR RAPIDS, IA 52402-3073
(319) 430-1211
Mailing address
1570 42ND ST NE STE 2A, CEDAR RAPIDS, IA 52402-3073

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001593
IA

Other

Enumeration date
06/21/2013
Last updated
09/09/2013
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