Individual
MS. AUTUMN SIMMS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2965 COLONNADE DR STE 100, ROANOKE, VA 24018-3541
(540) 989-1703
(540) 989-9141
Mailing address
2965 COLONNADE DR STE 100, ROANOKE, VA 24018-3541
(540) 989-1703
(540) 989-9141
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004340
VA
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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