Individual
STEPHANIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5925 GREENWELL SPRINGS RD, BATON ROUGE, LA 70806-1620
(225) 926-7911
(225) 926-7914
Mailing address
5925 GREENWELL SPRINGS RD, BATON ROUGE, LA 70806-1620
(225) 926-7911
(225) 926-7914
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1423
LA
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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