Individual
MAURINA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDP, LADC, CADC
Contact information
Practice address
154 WATERMAN ST STE 10, PROVIDENCE, RI 02906-3116
(774) 708-0310
Mailing address
154 WATERMAN ST STE 10, PROVIDENCE, RI 02906-3116
(774) 708-0310
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22905
RI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDP00950
RI
Other
Enumeration date
11/24/2025
Last updated
01/08/2026
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