Individual
KIMBERLY DAWN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
102 4TH ST, HILLSBORO, MO 63050-5043
(161) 887-7442
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(888) 924-3786
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2023030910
MO
101YM0800X
Mental Health Counselor
Primary
2025026687
MO
Other
Enumeration date
08/01/2023
Last updated
07/22/2025
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