Individual
MRS. LILLIAN CLEMONS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC, MAC
Contact information
Practice address
714 28TH AVE, TUSCALOOSA, AL 35401-1821
(205) 242-2303
Mailing address
7 COUNTRY CLUB LN, TUSCALOOSA, AL 35401-2531
(205) 242-2302
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07355
—
101YM0800X
Mental Health Counselor
Primary
50673
—
101YP2500X
Professional Counselor
1572
AL
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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