Individual
MISTY D WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11713 M CIR, OMAHA, NE 68137-2218
(402) 933-4411
Mailing address
11713 M CIR, OMAHA, NE 68137-2218
(402) 933-4411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10814
NE
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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