Individual
LESLIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
476 JAMES GATE CT, HOLLAND, MI 49424-2922
(616) 635-4985
Mailing address
17160 130TH AVE, NUNICA, MI 49448-9450
(616) 298-8190
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
MI
101YP2500X
Professional Counselor
Primary
6401225351
MI
Other
Enumeration date
12/23/2021
Last updated
09/10/2025
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