Individual
DEMETRICE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
132 W MAIN ST, WILLIAMSTON, NC 27892-2472
(252) 792-7812
(252) 792-7812
Mailing address
132 W MAIN ST, WILLIAMSTON, NC 27892-2472
(252) 792-7812
(252) 792-7812
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2888-A
NC
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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