Individual
MRS. TANESHIA MICHELLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(808) 433-8601
Mailing address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(808) 433-8601
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1004
HI
101YP2500X
Professional Counselor
Primary
180011537
IL
Other
Enumeration date
11/03/2016
Last updated
08/26/2025
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